Faced with multiple sclerosis, this treatment reduces the appearance of new brain lesions

Faced with multiple sclerosis, this treatment reduces the appearance of new brain lesions

The French laboratory Sanofi has just published the results of a study on frexalimab against multiple sclerosis. This anti-CD40L antibody would be capable of reducing the appearance of new brain lesions by 89%. Explanations from Dr Wilfrid Casseron, neurologist.

Developed by the Sanofi laboratory, frexalimab would have helped slow down the activity of the disease in people affected by multiple sclerosis.

A disease that attacks the myelin sheath of neurons

Multiple sclerosis (MS) affects nearly 100,000 people in Europe. This autoimmune disease will result in an attack by the lymphocytes of the immune system against myelin, the protective sheath of neurons.

By destroying this sheath, the disease causes various disorders, both motor and sensory. There are progressive MS and relapsing-remitting MS. In the first case, patients see their pathology progressively worsen over time. In the second case, the disease progresses in outbreaks.

A promising new monoclonal antibody for relapsing-remitting MS

As part of this study (a phase 2 trial), 129 patients affected by relapsing-remitting MS were divided into several groups:

  • A high dose of the anti-CD40L antibody frexalimab up to 1200 mg every 4 weeks (52 patients)
  • A lower dose with only 300mg every two weeks (51 patients)
  • A high dose placebo (12 patients) or low dose (14 patients) as well.

Results after 12 weeks: in patients treated with the monoclonal antibody, imaging data show a reduction in the appearance of new lesions, enhanced by the injection of gadolinium, a contrast product used in MRI.

  • The reductions were estimated by experts at 89% for participants who took high doses and 79% for participants who took lower doses.
  • But that’s not all. The researchers also saw a reduction in existing lesions by 88% and 80%, respectively.

96% of patients do not present a new active lesion after more than 5 months of treatment

Scientists are enthusiastic about these results. “Of note, at week 12, both doses of frexalimab studied achieved a pronounced decrease in new lesions – a standard measure of inflammatory activity in multiple sclerosis – and their effect was well maintained. maintained over time, especially in the group of patients treated with the highest dose of frexalimab. In fact, 96% of them did not present any new active lesions at week 24 of treatment. details Dr Patrick Vermersch from the University of Lille in a press release.

Furthermore, frexalimab was generally well tolerated and would have improved three disease indicators, namely: MSIS-29, a physical impact score for MS, plasma concentrations of light chain neurofilaments, a biomarker of neuro lesions. -axonal and plasma concentrations of CXCL13, a biomarker of inflammatory activity.

Monoclonal antibodies have revolutionized treatment

Questioned by TipsForWomens, Dr Wilfrid Casseron, neurologist in Aix-en-Provence, welcomes these first results. “Immunotherapy began to be developed to fight multiple sclerosis in the 2010s. The principle is to inject an antibody which will block the action of lymphocytes attacking myelin. first explains the doctor. “This is what seems to be happening here: we see that the treatment helps prevent the appearance of new lesions“.

But these treatments have drawbacks. “The monoclonal antibodies currently on the market are used as third line, when the patient has failed other treatments. Because if they block the lymphocytes, they also weaken the patient’s immune system, which is not without consequences. he adds. “We are then faced with more fragile patients, who must be vaccinated and protected more“.

“There is a lack of new treatments in progressive MS”

The specialist also regrets the lack of molecules available to fight against multiple sclerosis, in its progressive form. “We see that this study focuses on the relapsing-remitting form of the disease. However, we lack molecules to fight against progressive forms, research should be more interested in this“.

Before specifying that it is important to remember that these drugs also have a “cost for the community” and that if these advances are always positive, “they must be chosen for patients who really need them, while maintaining, for doctors, a gradation in the treatments offered”. Faced with these promising first results, a phase 3 trial – the last phase before the marketing authorization request – was launched.

Frexalimab is also the subject of phase II clinical trials in the treatment of Sjögren’s syndrome, systemic lupus erythematosus and type 1 diabetes.