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Tumour Necrosis Factor Neutralization in MS: A Cautionary Tale.

Bgw Arnason1

  • 1Barry GW Arnason Department of Neurology University of Chicago Surgery Brain Research Institutes 5812 South Ellis Avenue SBRI J209 (MC 2030) Chicago IL 60637 USA Tel: +1 773 702 6386 Fax: +1 773 702 9060

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Lenercept, a tumor necrosis factor (TNF) capture molecule, worsened multiple sclerosis (MS) attacks and symptoms in a clinical trial. This suggests caution when using TNF-lowering therapies for MS patients.

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Area of Science:

  • Neuroimmunology
  • Pharmacology

Background:

  • Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
  • Tumor Necrosis Factor (TNF) is a pro-inflammatory cytokine implicated in MS pathogenesis.
  • TNF capture molecules are investigated as potential MS therapeutics.

Purpose of the Study:

  • To evaluate the efficacy and safety of Lenercept, a TNF capture molecule, in patients with relapsing-remitting multiple sclerosis.
  • To assess the impact of Lenercept on MS attack frequency, duration, and patient-reported symptoms.

Main Methods:

  • A double-blind, placebo-controlled Phase II clinical trial.
  • Treatment with Lenercept or placebo for at least 24 weeks in patients with relapsing-remitting MS.
  • Monitoring of MS attacks, symptom severity, and magnetic resonance imaging (MRI) scans.

Main Results:

  • Patients receiving Lenercept experienced 1.5 times more MS attacks compared to placebo.
  • MS attacks were 1.5 times longer in duration for patients on Lenercept.
  • Significantly increased MS-related complaints were reported by patients treated with Lenercept.
  • MRI scans were uninformative in assessing treatment effects.

Conclusions:

  • Lenercept treatment was associated with a worsening of multiple sclerosis disease activity and symptoms.
  • Prior animal studies with TNF capture molecules were counter-predictive for MS.
  • Findings raise concerns about the use of other TNF-lowering agents, including certain antibiotics like ciprofloxacin, in MS patients.