Ibudilast decreases progression of brain atrophy in progressive multiple sclerosis

Written by Sharon Salt, Editor

According to new research led by scientists at the Cleveland Clinic (OH, USA), a promising drug – ibudilast – has been revealed to slow down brain shrinkage in progressive multiple sclerosis (MS).
Progressive MS is associated with gradual worsening of symptoms and increasing disability. While there are more than a dozen approved treatments for relapsing–remitting MS, none of these therapies have consistently demonstrated efficacy in slowing disability progression in patients with the progressive form, particularly those without evidence for active inflammation.

Ibudilast is an oral drug with activity on several biologic pathways with potential relevance to progressive MS. In 1989, the drug was approved in Japan for use in asthma and stroke. Additionally, ibudilast is also being studied in the USA for potential treatment of amyotrophic lateral sclerosis and drug addiction.

The study, which has been published in the New England Journal of Medicine, is a Phase II clinical trial that demonstrates that ibudilast decreased progression of brain atrophy in progressive MS patients by 48% compared with placebo. The 2-year SPRINT-MS study was conducted at 28 sites with 255 patients.

“These findings are significant for patients with progressive MS,” commented Robert Fox (Cleveland Clinic), principal investigator of the study. “Our hope is that the benefit of ibudilast in slowing brain shrinkage will also translate to decreased progression of associated physical disabilities in a future Phase III trial.”

Additionally, the SPRINT-MS study demonstrated the utility of advanced imaging in clinical trials to measure the impact of therapies on brain health. The potential application of imaging-based outcome measures may extend beyond progressive MS to other neurodegenerative disorders as well.

“Although a larger study is needed to confirm these findings, this promising study brings people with progressive MS, who currently do not have many treatment options, one step closer to a potential therapy,” concluded Robin Conwit, Program Director at the National Institute of Neurological Disorders and Stroke (MD, USA).

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Source: Fox RJ, Coffey CS, Conwit R et al. Phase II trial of ibudilast in progressive multiple sclerosis. N. Engl J. Med. doi:10.1056/NEJMoa1803583 (2018) (Epub ahead of print); https://newsroom.clevelandclinic.org/2018/08/29/cleveland-clinic-led-trial-shows-unprecedented-slowing-in-progressive-multiple-sclerosis/