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


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

“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).1

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.2 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.

NeurologyLive 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 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 label. Updated December 2012. Accessed March 31, 2021. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/103950s5136lbl.pdf
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