Tuesday, August 28, 2012

Multiple Sclerosis: is simplicity best or who win the race?

Very interesting article is here.
Just to summarize the situation with MS treatment: we have very nice treatment Copaxone which will become generic in a couple of years.  Then we have an experimental oral drug BG-12:
The company's experimental drug BG-12 (dimethyl fumarate) is in late stage clinical trials. BG-12 is designed to treat relapsing-remitting MS. When given twice daily, BG-12 cut the relapse rate by 44 percent at two years compared with a placebo. When given three times a day, it cut the relapse rate by 51 percent. If approved BG-12 could become the world's leading treatment for MS.
And now we have yet another experimental drug:  Laquinimod. At this moment I will not say much about the clinical trials, I will just see on the structures of the drugs! Something unusual? Yes, both compounds look extremely simple (heterocycle molecule on the picture is Laquinimod), especially BG-12! And I would like to ask anybody who works in this field: how in the world these simple compounds can treat MS??? One of the answers is here:
The mechanism of action is not fully understood, but preclinical studies have suggested that BG-12 may have complex neuroprotective and anti-inflammatory effects, acting via the Nrf-2 pathway. Activation of the Nrf-2 pathway defends against oxidative-stress induced neuronal death, protects the blood-brain barrier and supports maintenance of myelin integrity in the central nervous system.
But this answer is basically making the picture even more complicated…
I cannot connect the dots… And in my experience it usually does mean just one thing: BLUFF! And the first I could imagine that clinical trials with BG-12 were accomplished in a “creative” way. Let’s wait what FDA and EMA will say – we have 4 years to wait:
An extension study for participants on the DEFINE and CONFIRM studies to assess the long-term effectiveness and safety of BG-12 for a further two years. Estimated completion date June 2016.
I would like to wish a success for all the companies who are developing novel drugs against MS. I hope that BG-12, Laquinimod and other novel drugs will be helpful against MS – no doubts about it! What drug will be more useful? Only time will show…

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