Potential of Nasal Foralumab in Treating Non-Active Secondary Progressive MS: Tarun Singhal, MD, MBBS

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“One of the common problems we see in our clinic is that often patients continue to get worse clinically, but there are no changes on their MRI. In other words, we don't know the reason why patients are getting worse, despite having no new lesions or relapses.”

Foralumab (Tiziana Life Sciences), an investigational fully-human anti-CD3 monoclonal antibody, has a mechanistic function that binds to the T cell receptor and dampens inflammation by modulating T cell function, thereby suppressing effector features in multiple immune cell subsets. Findings from an open-label expanded-access program revealed that treatment with foralumab resulted in diminished microglial activation and clinical stability in patients with non-active secondary progressive multiple sclerosis (na-SPMS) who had progression independent of relapses (PIRA).¹

These results were presented at the 2024 American Academy of Neurology (AAN) Annual Meeting, held April 13-18, in Denver, Colorado, by lead author Tarun Singhal, MD, MBBS. At both the 3- and 6-month time points, 5 of 6 foralumab-treated patients (83%; 95% CI, 44%-97%) demonstrated a qualitative reduction in (F-18)PBR06-PET in multiple brain regions. Patients in the small-scale study also had stable Expanded Disability Status Scale scores and improvements in Modified Fatigue Impact Scale as a result of foralumab treatment.

Singhal, director of the PET Imaging Program in Neurologic Diseases at Brigham and Women’s Hospital, sat down with NeurologyLive® at the meeting to further discuss the significance of PIRA in the progression of MS. He also spoke about how PET imaging may aid in identifying hidden inflammation in the brain. Singhal, who also serves as an associate professor of neurology at Harvard Medical School, also explained the implications of the findings from the recent study assessing foralumab as a potential treatment for patients with na-SPMS.

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REFERENCES
1. Singhal T, Zurawski Jm Cicero S, et al. Treatment of PIRA with nasal foralumab dampens microglial activation and stabilizes clinical progression in non-active secondary progressive MS. Presented at: 2024 AAN Annual Meeting; April 13-18; Denver, CO.