Robert J. Fox, MD: Treating Progressive Multiple Sclerosis

“We’ve come to appreciate that progressive MS is 2 different components—we have the active inflammation that can still go on in progressive MS and can add to and contribute to the progression we see in progressive MS, and we have something else.”

Currently, the multiple sclerosis (MS) treatment landscape is both robust and in need. Although more than a dozen disease-modifying therapies are available to treat relapsing MS, the progressive form of the disease is lacking several strong treatments, with ocrelizumab (Ocrevus, Genentech) as the only current option.

With this challenge persisting, researchers such as Robert J. Fox, MD, a neurologist at Cleveland Clinic, have come to appreciate that progressive MS consists of 2 components: active inflammation, as well as a second portion that remains cloudy. While many, including Fox, are leaning toward that unknown component being neurodegeneration, the development of therapies to address the has become increasingly difficult.

Despite this, several are currently making their way through the pipeline, one being ibudilast, a small molecule normally used in the treatment of asthma and post-stroke vertigo in Asia. Fox and colleagues recently reported positive phase 2 results of the therapy, in which it showed a powerful effect on slowing brain atrophy in progressive MS.

At the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany, Fox sat with NeurologyLive to discuss these challenges, and to share his clinical experience with ibudilast.