Neuro News Roundup: Hot Topics and Key Insights From Women in Medicine

In recent months, the NeurologyLive^® team has been covering the news and conducting interviews with a variety of expert women physicians on the latest updates in the clinical care of individuals with different neurological conditions such as multiple sclerosis, migraine, epilepsy, Alzheimer disease, and many more.

For National Women Physicians Day—celebrated annually on February 3—the team has culminated some of the key clinical insights, data presentations, and hot topics in neurology that we have discussed with and that included leading women in medicine. These select items only scratch the surface of the full scale of women's contributions to the field, and NeurologyLive^®'s conversations with them.

Click here for more coverage of the latest news from NeurologyLive® that include women in neurology.

EXPERT INSIGHTS

Sharon Cohen, MD, FRCPC, a behavioral neurologist and medical director of the Toronto Memory Program at the University of Toronto, sat down with NeurologyLive^® to talk about the significance of the FDA approval for Eisai’s antiamyloid therapy lecanemab, as well as what it means for patients with Alzheimer disease (AD). She was an investigator on both Study 201 and Clarity AD (NCT03887455), the phase 3 confirmatory trial used in the most recent supplemental biologics license application.¹ In the interview, she discussed integrating the new therapy into society and the impacts a traditional approval could have vs accelerated approval.

Dolores Santamaria, MD, director of the Headache Center at Allegheny Health Network, specializes in treating patients with chronic migraine, and sat down with NeurologyLive® to discuss emerging concepts in the migraine field. She provided an overview on pituitary adenylate cyclase-activating polypeptide (PACAP), how it differs from calcitonin gene-related peptide (CGRP) inhibitors, such as the FDA approved erenumab (Aimovig; Amgen), and the conversations surrounding it.² While CRGP-targeting therapies have brought considerable relief to the clinical community, there are a proportion of patients with migraine who do not respond to these medications.

Ruth Ann Marrie, MD, PhD, FRCPC, professor of medicine at the University of Manitoba, and her colleagues from the International Advisory Committee on Clinical Trials in Multiple Sclerosis recently published a paper that suggested that the multiple sclerosis (MS) is driven by pathophysiological mechanisms, not clinical phenotypes.³ In an interview with NeurologyLive^®, Marrie discussed the major implications of the paper and whether it could have a serious impact on the indications of previously approved disease-modifying therapies. Additionally, she provided her thoughts on how the clinical community may react to the news, and if those who treat the disease may change their approach.

LATEST LITERATURE

International Panel of Experts Proposes New Diagnostic Criteria for MOG Antibody Associated Disease

Brenda Banwell, MD, chief of neurology and codirector of the neuroscience Center at the Children’s Hospital of Philadelphia, and her colleagues, proposed a new diagnostic criteria for myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) that includes the presence of MOG-IgG as a core criterion.⁴ Banwell and colleagues noted that the proposed criteria may have the potential to improve identification of individuals with MOGAD, thus improving the definition of long-term clinical outcomes, refining inclusion criteria for clinical trials, and identifying predictors of a relapsing vs monophasic disease course.

"Tools that quantify visual impairment would be valuable in MOGAD, given the predilection for the optic nerve," Banwell et al wrote. "The opticospinal impairment scale might prove useful in this regard. Prospective longitudinal OCT studies might further inform our understanding of the effect of MOGAD on the optic pathway and differences between MOGAD, multiple sclerosis, and AQP4-IgG-seropositive NMOSD."

Antiseizure Agent EQU-001 Shows Safety, Tolerability, and Preliminary Efficacy in Phase 2 Study

Jacqueline A. French, MD, professor of neurology, NYU Grossman School of Medicine, and president of the Epilepsy Study Consortium, was the lead investigator for a phase 2 clinical trial (NCT05063877) assessing found Equilibre’s antiseizure medication EQU-001. All told, the investigational agent was shown to be safe and well tolerated at all tested doses through 60 mg QD.⁵ French and colleagues noted a dose response trend in reduction of focal seizures, as well as decreases in key biomarkers.

"Patients living with epilepsy face the debilitating impact of focal seizures, as well as the debilitating side effects of many available medications,” French said in a statement.⁵ "There is a great need for new and efficacious medications that are well tolerated by patients with fewer AEs. If in fact EQU-001 is working through a novel anti-inflammatory mechanism, this would mean that the drug is acting directly on disease pathophysiology. I am very excited to see the results of the next study."

REFERENCES
1. Eisai submits supplemental biologics licence application to FDA for traditional approval of Leqembi (lecanemab-irmb) for the treatment of Alzheimer’s disease. News release. January 6, 2023. Accessed February 2, 2023. https://www.prnewswire.com/news-releases/eisai-submits-supplemental-biologics-license-application-to-fda-for-traditional-approval-of-leqembi-lecanemab-irmb-for-the-treatment-of-alzheimers-disease-301715905.html
2. Rubio-Beltrán E, Correnti E, Deen M, et al. PACAP38 and PAC1 receptor blockade: a new target for headache? J Headache Pain. 2018;19(1):64. doi:10.1186/s10194-018-0893-8
3. Kuhlmann T, Moccia M, Coetzee T, et al. Multiple sclerosis progression: time for a new mechanism-driven framework. Lancet Neurol. Published online November 18, 2022. doi:10.1016/S1474-4422(22)00289-7.
4. Banwell B, Bennett JL, Marignier R, et al. Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed critieria. Lancet Neurol. Published online January 24, 2023. doi:10.1016/S1474-4422(22)00431-8.
5. Equilibre Biopharmaceuticals announces positive topline results from phase 2 clinical trial of EQU-001 (NCT05063877) for safety, tolerability, and preliminary efficacy as adjunctive therapy for focal seizures in adults with epilepsy. News release. Equilibre Biopharmaceuticals. January 30, 2023. Accessed February 2, 2023. https://www.biospace.com/article/releases/equilibre-biopharmaceuticals-announces-positive-topline-results-from-phase-2-clinical-trial-of-equ-001-nct05063877-for-safety-tolerability-and-preliminary-efficacy-as-adjunctive-therapy-for-focal-seizures-in-adults-with-epilepsy/