Rituximab Trial for Progressive MS stopped

[KoKo]

Progressive MS Clinical Trial for Rituximab Stopped After Drug Fails to Show Effectiveness:

http://multiplesclerosisnewstoday.co...effectiveness/

[JerryD]

Somehow, I am not surprised ! These drug companies would market 'dog food' as a treatment for MS if they could get away with it !

[KoKo]

Hi Jerry

Somehow, I am not surprised ! These drug companies would market 'dog food' as a treatment for MS if they could get away with it !

Hopefully some decent drug company is trying to figure out what irritant, (virus, toxin, bacteria, etc.) is triggering the immune response in the first place, rather than creating drugs that shut down or mess with the entire immune system.

[Marco]

Isn't this article about the DELIVERY mechanism of the medication and not necessarily the medication? The way I read this is the intrathecal delivery mechanism did not produce sufficient disease inhibition. The intrathecal delivery mechanism allows the medication to reach the cerebrospinal fluid (CSF).

I do not believe this article is speaking about the efficacy of Rituximab delivered via infusion. Rituximab trials were essentially shelved due to patent expiration. The manufacturer then began developing Ocrelizumab with the same CD-20 targets and method of operation. The difference is Ocrelizumab would have full patent protection.


For full disclosure I am now on Rituximab, so I have a vested interest in the medication working!!!

[jreagan70]

This trial was about intrathecal rather than peripheral blood infusion. And while the title of the trial is "progressive MS," the enrollees all had secondary progressive rather than primary progressive MS.
Now two trials have shown that rituximab doesn't work intrathecally as well as peripherally:

1. This one in 2016 on secondary progressive MS
2. One in 2005 on primary progressive MS

So this is the end of intrathecal trials.

And it isn't only the mode of infusion that isn't effective in progressive MS. There already was a trial done with peripheral infusion on primary progressive back in 2009. Although there was a reduction in T2 lesion volume vs. placebo over 96, there was no overall effect on delay in progression. There was some effectiveness on delay in progression ONLY in a small subset of 1) YOUNGER PPMS patients 2) having an INFLAMMATORY component. Most PPMS is degenerative, and that's why drugs that work on inflammation don't work in PPMS.

So it's already been shown that rituximab doesn't work on PPMS, shown over 96 weeks. This is another drug prescribed for PPMS based on hope rather than factual effectiveness.

And that's why all the hype about ocrelizumab is so hard to believe. It was granted "breakthrough status" after showing effectiveness over only 12 weeks. After 12 weeks, then what? What happens at 96 weeks? The excitement shown even by medical professionals isn't supported by the evidence, so I don't get it at all.

Rituximab did show effectiveness in relapsing-remitting MS trials, and anecdotal reports from people with RRMS seem to be good. It didn't do anything for me though, and in fact made me flare up more often. Needless to say, I didn't continue after four infusions, as I was actually doing better on no DMD at all.

[KoKo]

jreagan

Thanks for helping us understand this technical stuff. You always do a good job of interpreting and explaining!

And it isn't only the mode of infusion that isn't effective in progressive MS. There already was a trial done with peripheral infusion on primary progressive back in 2009. Although there was a reduction in T2 lesion volume vs. placebo over 96, there was no overall effect on delay in progression. There was some effectiveness on delay in progression ONLY in a small subset of 1) YOUNGER PPMS patients 2) having an INFLAMMATORY component. Most PPMS is degenerative, and that's why drugs that work on inflammation don't work in PPMS.

So it's already been shown that rituximab doesn't work on PPMS, shown over 96 weeks. This is another drug prescribed for PPMS based on hope rather than factual effectiveness.

And that's why all the hype about ocrelizumab is so hard to believe. It was granted "breakthrough status" after showing effectiveness over only 12 weeks. After 12 weeks, then what? What happens at 96 weeks? The excitement shown even by medical professionals isn't supported by the evidence, so I don't get it at all.

I've wondered the same thing about ocrelizumab. They used younger patients, who didn't have much disease accumulation and who had relapses, to be in the trial. So to claim this new drug would be effective for those with PPMS, without the qualifiers used in the clinical trial, would be quite a stretch, in my opinion.

[JerryD]

Good reasoning, folks . I have learned to expect all kinds of 'qualifiers' in reading about trials and treatments, So far, there have not been any height or weight 'caveats' but patients age and length of disease duration seems to play a part . I am praying that Dr. Sadiq's MSC-NP treatment solves the puzzle ! Good luck

[hobbit]

$$$$

Recently checked into this and as I understand it, Rituximab was in it's 3 clinical trial when the patent ran out. Rather than introduce a drug at a potentially lower cost Roche trashed the studies, tweaked the drug and ta-da, we now have Ocrelizumab. A drug starting from square one.

It's all about the Benjamin's, never about the patients.

Peace,

Anna