Neuroimmunology clinical fellow, National Institutes of Health

Jemima Akinsanya, DO

“I think that the future of MS therapy is to begin to address not just the mechanisms by which new relapses occur, but also the mechanisms by which brain tissue at risk of deterioration goes bad.”

The effects of anakinra (NCT04025554) and tolebrutinib on paramagnetic rim lesions (PRL) in multiple sclerosis (MS) are being evaluated with the use of 7-Tesla magnetic resonance imagining (MRI) in 2 new open-label studies. The 2 studies are part of a new phase 2a clinical trial paradigm presented at the 

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021

, February 25-27, by first author Jemima Akinsanya, DO, neuroimmunology clinical fellow, National Institutes of Health (NIH).

Anakinra, approved by the FDA for the treatment of rheumatoid arthritis and neonatal-onset multisystem inflammatory disease in 2001, is a recombinant human interleukin-1 receptor antagonist.

 Tolebrutinib is an investigational, orally available, brain-penetrant Bruton’s tyrosine kinase (BTK) inhibitor. The study for anakinra is underway while the study for tolebrutinib is currently enrolling.

 spoke with Akinsanya and Daniel Reich, MD, PhD, senior investigator, National Institutes of Neurological Disorders and Stroke, NIH to learn more about how the treatments could benefit MS care. They also spoke about the importance of understanding MS mechanisms in the brain and being able to help patients with stable MRIs but clinically progressing disease courses.

For more coverage of ACTRIMS Forum 2021, click 

1. Akinsanya J, Absinta M, Dargah-zade N, et al. Toward the use of paramagnetic rim lesions in proof-of-concept clinical trials for treating chronic inflammation in multiple sclerosis. Presented at ACTRIMS Annual Forum; February 25-27, 2021. Poster P126.
2. Kineret® (anakinra) for injection, for subcutaneous use. FDA label. Updated December 2012. Accessed March 31, 2021. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/103950s5136lbl.pdf

Videos

The duo from the National Institutes of Health discussed how monitoring and treating paramagnetic rim lesions can improve patient care in multiple sclerosis. 

Understanding Mechanisms of MS Chronic Inflammation: Jemima Akinsanya, DO, and Daniel Reich, MD, PhD

“There are some places, like specialty MS clinics, where the 7-T is used as the primary MRI scan for the patients in that clinic. And I imagine that if we see that 7-T really offers a much better look at the imaging features of relevance to patients then that usage will grow over time. And this is one area where that might be the case.”

A new phase 2a clinical trial paradigm using 7-Tesla magnetic resonance imagining (MRI) to evaluate 

paramagnetic rim lesions (PRL) in multiple sclerosis

 The 2 open-label studies investigating anakinra (NCT04025554) and tolebrutinib were presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021, February 25-27, by first author Jemima Akinsanya, DO, neuroimmunology clinical fellow, National Institutes of Health (NIH).

Anakinra was approved by the FDA for the treatment of rheumatoid arthritis and neonatal-onset multisystem inflammatory disease in 2001.

 It is a recombinant human interleukin-1 receptor antagonist, and its study is underway. Tolebrutinib is an investigational, orally available, brain-penetrant Bruton’s tyrosine kinase (BTK) inhibitor and its study is currently enrolling.

 spoke with Akinsanya and Daniel Reich, MD, PhD, senior investigator, National Institutes of Neurological Disorders and Stroke, NIH to learn more about their investigations as well as the use of 7-Tesla MRIs in research and clinical practice. They discussed the potential of the technology and future usage.

For more coverage of ACTRIMS Forum 2021, 

The duo from the National Institutes of Health discussed the advantages of the ultra-high resolution imaging technology in research. 

7-Tesla MRI Use in Research: Jemima Akinsanya, DO, and Daniel Reich, MD, PhD

“It's very disheartening as a clinician to not be able to provide more options for [patients with progressive MS]. It’s a huge quality of life hindrance for patients that to be able to provide them with treatments that can help slow the neurodegeneration and not just the acute inflammation would have a huge impact on them. So, I'm excited for that.”

phase 2a clinical trial paradigm for multiple sclerosis

 (MS) is underway, with 2 open-label studies evaluating the effects of anakinra (NCT04025554) and tolebrutinib on 7-Tesla magnetic resonance imaging (MRI) paramagnetic rim lesions (PRL).

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum

 Tolebrutinib is an investigational, orally available, brain-penetrant Bruton’s tyrosine kinase (BTK) inhibitor. Although the study for anakinara is already underway, the study for tolebrutinib is currently enrolling.

 spoke with Akinsanya to learn more about anakinra and tolebrutinib as well as the 2 studies in the clinical program. She also discussed further research she would like to see conducted in progressive MS.

1. Akinsanya J, Absinta M, Dargah-zade N, et al. Toward the use of paramagnetic rim lesions in proof-of-concept clinical trials for treating chronic inflammation in multiple sclerosis. Presented at ACTRIMS Annual Forum; February 25-27, 2021. Poster P126.
2. Kineret® (anakinra) for injection, for subcutaneous use. FDA label. Updated December 2012. Accessed March 24, 2021. 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/103950s5136lbl.pdf

The Neuroimmunology Clinical Fellow at the National Institutes of Health discussed the evaluations of 2 therapies in multiple sclerosis that she is partaking in. 

Jemima Akinsanya, DO

Articles

Understanding Mechanisms of MS Chronic Inflammation: Jemima Akinsanya, DO, and Daniel Reich, MD, PhD

7-Tesla MRI Use in Research: Jemima Akinsanya, DO, and Daniel Reich, MD, PhD

Studies of Anakinra and Tolebrutinib in MS Paramagnetic Rim Lesions: Jemima Akinsanya, DO