New multiple sclerosis treatment to repair myelin is at phase 2 trial stage of development

Anti-LINGO-1 (also known as BIIB033) is a new MS treatment being development by the pharmaceutical company Biogen. It is currently being tested in people with optic neuritis, relapsing remitting MS and secondary progressive MS in phase 2 clinical trials.

LINGO is a protein found in nerve cells and myelin-making cells called oligodendrocytes. Blocking the activity of this protein with an antibody called anti-LINGO-1 has been shown to result in myelin repair in animal models of MS.

In April 2015, results from a phase 2 clinical trial testing the safety effectiveness of anti-LINGO-1 as a treatment for optic neuritis were announced at a conference. The trial involved 82 participants with a first episode of acute optic neuritis. They were given six doses of anti-LINGO-1 (100 mg per kilo weight, once every four weeks for 20 weeks) as an intravenous infusion or a placebo.

Biogen, the manufacturer, found that those taking anti-LINGO-1 had better signalling along the optic nerve, suggesting myelin repair had taken place. Participants had a 41% improvement in nerve signalling compared to the placebo group.

 While these results still need to be published in a scientific journal, these results are the first indication that a drug could promote remyelination in people.

Another phase 2 trial, also by Biogen, testing the safety and effectiveness of anti-LINGO-1 in people with relapsing remitting or secondary progressive MS began in April 2013 and is due for completion soon.

This trial involves 416 participants, who are being divided into five groups, each receiving either three, 10, 30 or 100 mg of anti-LINGO-1 per kilo weight, or a placebo, once every four weeks for 72 weeks. All participants are also receiving beta-interferon-1a injections once weekly. Researchers are investigating whether anti-LINGO-1 can improve the function of the nervous system, cognitive ability or disability over the 72-week timeframe.

Some adverse effects of MS were reported: two participants had hypersensitivity reactions to the infusion itself, while one participant had an increase in liver enzymes – which was resolved by discontinuing the treatment.

If the phase 2 trial of anti-LINGO-1 in people with MS is successful, a larger scale phase 3 trial will be carried out to confirm its effectiveness as a treatment for people with MS. Research is still at an early stage and it will be a few years before it is known whether any of these drugs are effective treatments for people with MS.

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