Multiple Sclerosis Society of Canada

Treatments in Development

There has been a surge in the development of treatments for MS over the last two decades. Currently, there are 11 disease-modifying therapies approved by Health Canada. The development of new treatments is a time consuming and expensive process, and there is no guarantee as to whether a treatment under trial will be approved by Health Canada. This emphasizes the importance of stimulating research that will uncover new therapeutic targets for MS. Here are some treatments in the pipeline.

Emerging Treatments for RRMS

Daclizumab
Laquinimod
Ocrelizumab
Minocycline
Anti-LINGO-1
Ofatumumab
ONO-4641
Vatelizumab
Siponimod

Emerging Treatments for Progressive MS

Fingolimod
Ocrelizumab
MD1003
Siponimod
Natalizumab
Simvastatin
Amiloride
Ibudilast
Riluzole

Trends in Emerging Treatments

T cells vs. B cells

T cells are a type of white blood cell involved in cell-mediated immunity, an immune response that does not involve antibodies. B cells are another type of white blood cell involved in humoral immunity, an immune response mediated by antibodies. Historically, many MS treatments have targeted T cells in their therapeutic approach. Recently, research has targeted B cells as a therapeutic treatment.

Monoclonal antibodies

An antibody is a protein that recognizes a unique biological target, called an antigen. Monoclonal antibodies are produced in a lab and have very specific targets (antigens) that they bind to- similar to the specificity between a lock and key. Natalizumab and alemtuzumab are currently available monoclonal antibodies prescribed for MS. Ocrelizumab, daclizumab, and ofatumumab are monoclonal antibodies currently under development. Monoclonal antibodies mimic the antibodies that are produced naturally in the body, and work by blocking the activity of the immune cells that drive MS.

Interferons

Interferons are chemicals produced in the body which help to regulate the immune response. They have a long history of being used to treat MS. Recently, advancements have been made in further developing these treatments by extending their activity in the body which means a less frequent dosing schedule (for example, peginterferon beta-1a). Other MS drugs are also being tested under reduced dosing schedules (for example, copaxone).

Repair treatments

Treatments available for MS are aimed at modifying the immune system and slowing the progression of the disease and disability. Novel treatments are now focusing on the potential to protect and repair the damage caused by MS (remyelination). Although very preliminary, research is underway examining the ability of drugs to protect and remyelinate neurons (anti-LINGO-1).

References

2014 Multiple Sclerosis Therapeutic Update. Cree et al., 2014.
Monoclonal antibodies in treatment of multiple sclerosis. Rommer et al., 2014.
Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies and Treatment Strategies. Wingerchuck et al., 2014.
Drugs in Development for Relapsing Multiple Sclerosis. Ali et al., 2013.
Optimizing therapeutics in the management of patients with multiple sclerosis: a review of drug efficacy, dosing, and mechanisms of action. Damal et al., 2013.
Current and emerging therapies in multiple sclerosis: a systematic review. Castro-Borrero et al., 2012.