Promising Nasal Administration Treatment for Non-Active Secondary Progressive MS: Tarun Singhal, MD, MBBS

WATCH TIME: 5 minutes

"This approach with the nasal administration of the drug, we believe, actually leads to a modulation of the immune system in such a way that it makes it more regulatory in its nature."

In the current care landscape for multiple sclerosis (MS), the majority of treatments are based mainly on injectable drugs which has reports of low patient compliance. Newer therapies for nasal delivery such as foralumab (Tiziana Life Sciences) are being investigated in MS and may be a potential alternative for patients who may experience swallowing disturbances or prefer non-injectable drugs. According to a study published in the Journal of Neuroimmunology, investigators noted that future research should confirm the superiority of nasal administration of drugs as a potential treatment method in MS for its clinical effectiveness.¹

New data from an open-label expanded-access program revealed that treatment with foralumab resulted in damped microglial activation and clinical stability in patients with non-active secondary progressive MS (na-SPMS) who had progression independent of relapses (PIRA).1 At both 3 and 6 months, 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 treatment with foralumab.²

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, director of the PET Imaging Program in Neurologic Diseases at Brigham and Women’s Hospital. At the meeting, Singhal sat down with NeurologyLive^® to discuss how nasal administration differs from other forms of drug delivery in treating MS. He also talked about the potential mechanisms behind modulation of the immune system through intranasal administrated drugs. In addition, Singhal spoke about how the potential success of this approach in MS treatment might pave the way for its application in other neurodegenerative diseases.

Click here for more coverage of AAN 2024.

REFERENCES
1. Duchi S, Ovadia H, Touitou E. Nasal administration of drugs as a new non-invasive strategy for efficient treatment of multiple sclerosis. J Neuroimmunol. 2013;258(1-2):32-40. doi:10.1016/j.jneuroim.2013.02.013
2. 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.