Anakinra and Tolebrutinib for Chronic Inflammation in MS: Daniel Reich, MD, PhD


The senior investigator at the National Institutes of Neurological Disorders and Stroke discussed 2 treatments currently being evaluated for use in multiple sclerosis.

“The chronic inflammation is driven probably both by lymphocytes, T and B cells, which really drive the acute inflammation, but also by the innate immune cells, and particularly the innate immune cells of the brain microglia. So, we've been thinking about which therapies might modulate the activation of those cells, and the mechanisms they use to damage brain tissue.”

The effects of anakinra (NCT04025554) and tolebrutinib on 7-Tesla magnetic resonance imaging paramagnetic rim lesions in multiple sclerosis (MS) are being evaluated in a new phase 2a clinical trial paradigm.1 The 2 open-label studies were presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, February 25-27, by Jemima Akinsanya, DO, Neuroimmunology Clinical Fellow, National Institutes of Health (NIH).

Anakinra, a recombinant human interleukin-1 receptor antagonist, was approved by the FDA for the treatment of rheumatoid arthritis and Neonatal-Onset Multisystem Inflammatory Disease in 2001.2 Tolebrutinib, on the other hand, is an investigational, orally available, brain-penetrant Bruton’s tyrosine kinase (BTK) inhibitor. 

NeurologyLive spoke with a principal investigator of the study, Daniel Reich, MD, PhD, senior investigator, National Institutes of Neurological Disorders and Stroke, NIH, to learn more about anakinra and tolebrutinib’s mechanisms of action and potential in MS. He stressed that while many therapies are available for central nervous system acute inflammation in MS, further investigation is needed to understand chronic inflammation’s role in the disease. 

For more coverage of ACTRIMS Forum 2021, click here.

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. 2012.
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