Friday, July 18, 2014

Multiple Sclerosis Treatments That Show Promise

Multiple sclerosis treatment #4: Laquinimod
Laquinimod, a once-a-day oral medication, is a small, synthetic molecule that decreases cytokines, molecules secreted by immune cells that stir up inflammation and attract other immune cells to attack the brain, Coetzee explains.

Why the excitement? "It turns down the production of cytokines and reduces inflammatory activity," he says.

In one of two Phase 3 trials, researchers found that it reduced relapse rates by 23%, disability by 36%, and brain atrophy, or the loss of nerve cells, by 33.8%.

Also, popping a pill is more convenient and comfortable for MS patients than injecting or infusing medications.

"Although patients can give themselves injections or have a loved one give them, most would prefer not to deal with the discomfort and inconvenience," Coetzee says. "Monthly infusions require traveling to an infusion site or doctor's office, spending a few hours out of the work day."

Oral options are important because they're convenient and may improve compliance, he says.

Potential pitfalls: Some patients had temporary, elevated liver enzyme levels, which can signal inflammation in or damage to liver cells.

But laquinimod did not lead to liver problems in the clinical trials, Coetzee says.

"[It] also didn't show as much benefit compared to a placebo as some of the other drugs did," Coetzee says. "More data is needed to show its benefits."

Availability: In early 2014, European regulators recommended that laquinimod not be approved for marketing in Europe because of the drug's safety risks. Still, the manufacturer remains committed to laquinimod's development to treat MS and hopes to gain FDA approval by 2018.