New MS Drug Reduces Lesions and Extends Time to Relapse...CLICK HERE FOR MORE:
"An investigational oral drug for relapsing multiple sclerosis reduced the number of lesions seen on MRI, produced rapid reductions in clinical disease activity, and significantly prolonged the time to relapse, found researchers here.

Patients who were switched to the drug, fingolimod (FTY720), after being on placebo also had a reduction in MS lesions and improvement of MS symptoms, reported Ludwig Kappos, M.D., from University Hospital in Basel, and colleagues, in the Sept. 14 issue of the New England Journal of Medicine.

Nearly 80% of patients who had received the drug continually for a year were free of relapses during that time, compared with about 66% of patients who received placebo for the first six months, then fingolimod for the next six months.

'Our results demonstrate that oral fingolimod given once daily provides significant and rapid improvement in MRI measures of inflammation and in relapse-related clinical end points in patients with relapsing multiple sclerosis,' the authors wrote.

Fingolimod is an immuomodulating agent, developed by Novartis, that appears to work by trapping inflammatory lymphocytes in lymph nodes, thereby preventing their migration into the central nervous system. It's a chemical derivative of a metabolite produced by a fungus used in traditional Chinese medicine.

The drug's development pathway was illuminated by the mechanism of action of another drug for MS [Tysabri], Dr. Massberg and Dr. von Andrian suggested. "The clinical importance of T-cell migration in patients with multiple sclerosis has been impressively demonstrated by the therapeutic effects of natalizumab [Tysabri], a monoclonal antibody that blocks the α4 integrin-dependent adhesion of blood-borne encephalitogenic T cells and macrophages to microvessels in the CNS," they wrote.

"Fingolimod also interferes with T-cell migration," they continued, "but at a different step; the drug prevents lymphocytes from leaving lymph nodes and other tissues. The sequestration of T and B lymphocytes in lymphoid tissues results in the nearly complete disappearance of lymphocytes, but not myeloid leukocytes, from the blood."

In an accompanying perspective article, Steffen Massberg, M.D., Ph.D., and Ulrich H. von Andrian, M.D., Ph.D., both of Harvard Medical School, wrote that 'the results of the current proof-of-concept study by Kappos et al. are certainly promising and should provide a strong incentive for long-term follow-up trials on a large scale.....[MORE: - CME Teaching Brief - MedPage Today']"