Remibrutinib Phase 3 Results in RMS, Blood Pressure Variability Findings, and Updated Stroke Rehabilitation Guidelines

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Welcome to the Neurology News Network, my name is Louie Pasculli and here’s a look at some of the top stories in Neurology.

Remibrutinib (Novartis), an oral Bruton tyrosine kinase (BTK) inhibitor, reduced annualized relapse rate (ARR) vs teriflunomide in 2 phase 3 trials of adults with relapsing multiple sclerosis (RMS), according to a Novartis announcement.¹ The REMODEL-1 and REMODEL-2 data were presented in a late-breaking session at MSToronto2026 and published simultaneously in The Lancet.² The 100 mg dose lowered ARR by 35.2% and 31.2%, respectively.¹

Remibrutinib is a highly selective, covalent, oral BTK inhibitor discovered at Novartis. The company plans to seek regulatory approval for the agent in RMS globally. A 25 mg formulation (Rhapsido) is approved for chronic spontaneous urticaria in the US and the European Union.¹

“The REMODEL trial results showed that oral remibrutinib delivered a significant reduction in relapse activity while also showing a clinically meaningful effect on confirmed disability progression in people living with relapsing MS,” Heinz Wiendl, MD, professor of neurology and chair of the Department of Neurology and Neurophysiology at the Medical Center, University of Freiburg, said in a statement.¹ “As treatment goals in MS continue to evolve beyond relapse control alone, these efficacy findings, together with the favorable safety profile, suggest remibrutinib has the potential to deliver a meaningful, differentiated treatment option for people living with RMS.”

Staying with conference news, a target trial emulation pooling individual-participant data from the ACCORD-BP and SPRINT trials found that calcium channel blocker (CCB) based antihypertensive regimens were associated with lower visit-to-visit systolic blood pressure variability than renin-angiotensin system (RAS) inhibitor based regimens, despite similar achieved mean blood pressure. The difference was not accompanied by a difference in major adverse cardiovascular events (MACE) across treatment strategies.³

Yue Qiao, of China, presented the findings at the World Stroke Congress (WSC 2026), held October 21-23, 2026, in Seoul, Republic of Korea. For context, a target trial emulation is an analytic method designed to approximate the results of a hypothetical randomized trial using existing data, in this case individual-participant data pooled from 2 previously completed randomized trials rather than new clinical trial enrollment.

Researchers used propensity score matching to compare 3 first-line antihypertensive drug classes, used as monotherapy or in combination: RAS inhibitors, calcium channel blockers, and diuretics. The primary outcome was visit-to-visit systolic blood pressure variability (BPV), measured using variation independent of the mean (VIM); MACE and its individual components were assessed as secondary outcomes.

Switching gears, the recently published 2026 American Heart Association/American Stroke Association (AHA/ASA) guidelines for adult stroke rehabilitation and recovery provided updated recommendations for clinicians caring for patients following stroke. The guidance addresses key aspects of rehabilitation and recovery, with an emphasis on supporting patients as they navigate the different stages of care.⁴

Translating updated recommendations into clinical practice can present challenges for clinicians, particularly as they work to address the varied needs of patients and coordinate care across different settings. Understanding how these recommendations apply to everyday practice remains an important consideration for clinicians involved in stroke rehabilitation.

In honor of World Stroke Day, celebrated October 29th, NeurologyLive spoke with Sara Cuccurullo, MD, FAAPMR, chair, medical director, and vice president at Hackensack Meridian JFK Johnson Rehabilitation Institute, to discuss the updated guidelines and their implications for clinical practice. Additionally, Talya Fleming, MD, FAAPMR, medical director of the institute's Stroke Recovery Program, shared her perspectives on the recommendations and their application to patient care.

To read the full pieces and to get more direct access to expert insight, head to NeurologyLive.com. Be sure to tune in next week to remain informed on the latest in neurology. I’m Louie Pasculli, thanks for watching Neurology News Network.

REFERENCES
1. Novartis remibrutinib delivered comprehensive disease control in Phase III RMS trials, with proven, robust safety profile. Novartis. News release. Published October 23, 2026. Accessed October 23, 2026. https://www.globenewswire.com/news-release/2026/10/23/3387514/0/en/novartis-remibrutinib-delivered-comprehensive-disease-control-in-phase-iii-rms-trials-with-proven-robust-safety-profile.html
2. Wiendl H, Bermel R, Airas L, et al. Remibrutinib versus teriflunomide in relapsing multiple sclerosis (REMODEL-1 and REMODEL-2): two randomised, phase 3 trials. Lancet. 2026; 0. Doi: 10.1016/S0140-6736(26)02058-1
3. Qiao Y, et al. Visit-to-visit blood pressure variability and cardiovascular outcomes across antihypertensive regimens: a target trial emulation study. Presented at: World Stroke Congress 2026 (WSC 2026); October 21-23, 2026; Seoul, Republic of Korea.
4. Prabhakaran S, Gonzalez NR, Zachrison KS, et al.2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. ASA|AHA Journals.2026;57(8)Doi: 10.1161/STR.0000000000000513