Advances in Multiple Sclerosis From ECTRIMS 2022

Gavin Giovannoni, MBBch, PhD

Disclosures

November 15, 2022

Prof Gavin Giovannoni, from Queen Mary University of London, United Kingdom, offers his pick of top presentations in multiple sclerosis from the 38th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).

He begins by highlighting two of the key themes at the meeting, that of 'flipping the pyramid' to offer the most effective therapies upfront, and moving beyond inflammatory disease activity as a treatment target.

Prof Giovannoni goes on to discuss Bruton tyrosine kinase (BTK) inhibitors and their role in MS treatment. One study revealed that the BTK inhibitor evobrutinib had no impact on immune responses to mRNA COVID-19 vaccination, raising questions about its potency. In another, a novel BTK inhibitor showed promise in the preclinical setting.

Next, the ARISE trial looked at dimethyl fumarate in radiologically isolated syndrome, finding that it significantly delayed progression to multiple sclerosis.

Prof Giovannoni then turns to two registry studies. One showed that ocrelizumab was superior to rituximab in reducing relapses, whereas the second showed no difference between natalizumab and autologous hematopoietic stem cell transplant, suggesting that the latter can be avoided.

Finally, he reports on the PREVANZ study, which revealed that vitamin D supplementation does not prevent progression to definitive multiple sclerosis in high-risk patients.

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