Therapeutic Focuses of MS and the Need to Reach NEDA Status: Stuart Silverman, MD

WATCH TIME: 3 minutes

"Skipping ahead 30 years [from the 1980s], we have probably 20 [disease-modifying therapies]. Each time we have one, we learn more about the mechanism of action. We try to have less side effects and more easy availability."

Although there is no cure for multiple sclerosis (MS), over the past 2 decades, there has been an explosion in therapeutics, with several new products for mainly the relapsing forms of the disease. For primary progressive MS, ocrelizumab (Ocrevus; Genentech) remains the only FDA-approved disease-modifying therapy. In contrast, patients with relapsing MS have several treatment options at their disposal, including injectables, oral therapies, and infusions. Despite the exponential growth for relapsing MS, there are still several agents in development, including a new treatment class called Bruton tyrosine kinase (BTK) inhibitors.

Fenebrutinib, a BTK inhibitor developed by Genentech, is currently being assessed in a large-scale, phase 3 study called FENhance (NCT04586023). The study will randomly assign 1400 total participants with relapsing MS between the ages of 18 and 55 to either treatment with fenebrutinib or teriflunomide (Aubagio; Sanofi), another previously approved agent. Of those, Allegheny Health Network (AHN) will be responsible for 4 such participants.

While there have been notable advances in MS therapeutics, the next biggest goal is to find agents that effectively help patients reach no evidence of disease activity (NEDA), says Stuart Silverman. Silverman, a neurologist at AHN, recently sat down with NeurologyLive® to discuss the reasons behind continued drug development for various forms of MS, despite the numerous options available. He harped on improving quality of life and acclimating more patients back into the workforce as realistic treatment goals going forward.