Once-Nightly Sodium Oxybate Preferred in Narcolepsy, ABBV-951 Shines in PD, Ocrelizumab Demonstrates Improved Cognitive Function in Progressive MS

Neurology News Network for the week ending April 9, 2022. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

This week Neurology News Network covered a study on the patient preferences of those with narcolepsy, new results on 24-hour/day subcutaneous foslevodopa/foscarbidopa, and the long-term effect of ocrelizumab in progressive MS.

Welcome to this special edition of Neurology News Network. I’m Marco Meglio. This week’s episode is geared around the 2022 American Academy of Neurology Annual meeting.

Interim results from the ongoing, open-label extension RESTORE study indicated that patients with narcolepsy prefer treatment with once-nightly sodium oxybate (ON-SXB) using FT218 (Avadel) to twice-nightly SXB. Twice-nightly SXB also led to more missed treatment doses and worsened narcolepsy symptoms the next day. The analysis included participants aged at least 16 years with narcolepsy type 1 or 2 who completed the phase 3 REST-ON study or eligible participants receiving stable doses of twice-nightly SXB for at least 1 month. Patients who switched from twice-nightly SXB to ON-SXB maintained their original dosage level and completed patient preference questionnaires 3 months after switching. They also completed a nocturnal adverse event (AE) questionnaire at baseline. The results, presented AAN 2022 showed that 94.3% (33 of 35) of those who responded preferred ON-SXB to twice-nightly SXB. Of the 60 patients who completed nocturnal AE questionnaires, 63% (38 of 60) unintentionally missed their second twice-nightly SXB dose within the past 3 months; Of these, 84% felt worsened symptoms the next day.

Six-month interim results from a phase 3, open-label, single-arm study showed that 24-hour/day subcutaneous foslevodopa/foscarbidopa, ABBV-951, significantly reduced motor complications, improved morning akinesia, sleep disturbances, and quality of life in patients with advanced Parkinson disease. highlighted the therapeutic benefit this alternative approach has for this patient population. All in all, ABBV-951 was proven to be well-tolerated, with systemic and skin adverse events (AEs) that were consistent with those of levodopa and other medications with subcutaneous delivery. Lead author Jason Aldred, MD, FAAN, neurologist, Selkirk Neurology, and colleagues included 223 levodopa-responsive patients (60.1% male; 83.4% white; mean age, 64 years) with a minimum of 2.5 hours of OFF time per day. As of March 30, 2021, the study cut-off, 92.4% (n = 206) of treated patients reported at least 1 treatment-emergent AE, most of which were mild or moderate in severity.

New 1-year interim data from the single-arm phase 3b CONSONANCE trial (NCT03523858) of ocrelizumab (Ocrevus; Genentech) in patients with progressive multiple sclerosis (MS) suggest that the therapy is associated with stabilized and improved cognitive function in the majority of patients while maintaining low levels of both disease activity and progression.1,2 The trial includes patients with both primary (PPMS; n = 325) and secondary progressive multiple sclerosis (SPMS; n = 304), in which they received ocrelizumab 600 mg every 24 weeks for up to 4 years. The overall cohort’s mean age was 48.5 years (52.3% female). The cognitive analysis showed that after 1 year, patients with SPMS and PPMS reported a mean change of 12.6% (SD, 93.3) and 8.6% (SD, 39.1) on Symbol Digit Modalities Test scores, for an overall mean change of 10.7% (SD, 72.8) from the overall mean baseline score of 42.3 points.

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