Treatments in Development
There has been a surge in the development of treatments for MS over the last two decades. Currently, there are 18 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
| Fenebrutinib | Phase III |
| Tolebrutinib | Phase III |
| Remibrutinib | Phase III |
| Frexalimab | Phase III |
| IMU-838 | Phase III |
| Orelabrutinib | Phase II |
| RIPK1 inhibitor | Phase II |
Emerging Treatments for Progressive MS
| Masitinib | Phase III |
| Tolebrutinib (PPMS) | Phase III |
| Tolebrutinib (non-active SPMS) | Phase III |
| Fenebrutinib (PPMS) | Phase III |
| Frexalimab (non-active SPMS) | Phase III |
| Simvastatin | Phase III |
| IMU-838 | Phase II |
| RIPK1 inhibitor | Phase II |
| Lipoic Acid | Phase II |
| Hydroxychloroquine and indapamide | Phase II |
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, alemtuzumab, ocrelizumab and ofatumumab are currently available monoclonal antibodies prescribed for MS. 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.
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.
Stem Cells
The unique properties of stem cells provide promise for new treatments that can slow/halt MS disease activity and repair tissue damage in the central nervous system. In addition to ethical concerns surrounding the use of stem cells, legitimate health concerns exist as well. Stem cell treatments can be invasive and risky procedures, as these cells have the potential to develop into tumours.
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