Research News
Recent News and Study Updates in MS Research
By Tom Garry
Edited by Susan Wells Courtney
Reviewed by Dr. Barry A. Hendin, MSAA Chief Medical Officer
Fenebrutinib Impacts Inflammation in RMS
In a recent study, an international team of researchers reported that people with relapsing MS who took the investigational disease-modifying therapy (DMT) fenebrutinib had “near complete suppression of acute inflammatory disease activity” over one year of treatment.1 Fenebrutinib belongs to a class of medications known as Bruton tyrosine kinase inhibitors, or BTKis.
BTKis have shown an ability to cross the blood-brain barrier and to modulate persistent immune system activation within the central nervous system. This includes the modulation of disease-associated microglia and B cells (immune system cells), potentially affecting the smoldering neuroinflammation thought to be a major driver of disability accumulation in multiple sclerosis.
In addition, fenebrutinib affects both the innate and adaptive immune systems, the two main types of immunity. Innate immunity is nonspecific to different antigens. A person is born with this type of protection and it responds quickly to almost any foreign organism (or “microbe”) to prevent infection. Adaptive immunity, also known as “acquired immunity,” takes several days to develop and reacts to a specific antigen.
The FENopta open-label extension study involved 99 people with relapsing MS (RMS). All of them had participated in the double-blind Phase II FENopta study, with some having received 200 mg of fenebrutinib orally twice a day and others having been assigned at random to receive placebo. In the open-label extension (OLE) study, all participants received 200 mg of fenebrutinib twice a day.
Through 48 weeks of treatment in the OLE study, 96% of participants were relapse-free, and the annualized relapse rate for the group was 0.04. Similarly, 99% of study participants did not have any new lesions marked by gadolinium enhancement – an indicator of inflammatory activity – on magnetic resonance imaging (MRI).
Encouraging Results in Frexalimab Study
In another recent study, researchers found that over the course of two years, the investigational disease-modifying therapy (DMT) frexalimab reduced disease activity in people with relapsing forms of MS, while also being well tolerated.2 Frexalimab is a monoclonal antibody – a protein that affects the immune response by blocking the CD40/CD40L pathway, which is believed to play a role in multiple sclerosis. Frexalimab regulates both innate and adaptive immunity; these two main types of immunity are described in more detail in the previous section.
This medication was evaluated in a 12-week, double-blind, Phase II trial in which 129 people with relapsing MS were assigned at random to receive frexalimab every four weeks by intravenous (IV) infusion, every two weeks by subcutaneous (SC) injection, or placebo. At Week 12, the study found that the intravenous group experienced an 89% reduction in new gadolinium-enhancing T1 lesions relative to those in the placebo group.
At the end of the 12-week trial, study subjects were given the opportunity to enter an open-label extension study in which all participants would receive either 1200 mg of IV frexalimab or 1800 mg by SC injection every four weeks. As of July 2024, 106 people who had entered the open-label extension study remained on treatment.
At Week 96, the average numbers of gadolinium-enhancing T1 lesions were 0.1 in people who received IV frexalimab and ≤0.4 in people who received frexalimab by subcutaneous injection. Additionally, 92% of participants in the open-label extension study were relapse-free.
Use and Impact of Patient Messaging Portals
Secure electronic messaging portals provide a welcome alternative to playing “phone tag” with a clinician’s office when you need a question answered or medication refilled. But how are people with MS making use of this technology platform, and what impact is the need to respond to messages from multiple patients, often at the end of a long workday, having on providers?
MSAA is examining both of those questions through two surveys, one sent to people with MS and the other distributed to physicians and nurse practitioners.3 While survey responses from the healthcare professionals (HCPs) are still being collected and analyzed, information from the 18-question patient survey found that 43% of respondents said portal messaging was their preferred means of communicating with their healthcare team.
The survey also found that the most frequently reported use for messaging was requesting medication refills (67%). Other common uses included requesting medical advice (53%), scheduling appointments (42%), conveying urgent concerns (39%), clarifying questions from a recent visit (38%), and asking time-sensitive medication questions (37%). Several of the study’s 426 participants noted the value that messaging portals provide, particularly when a provider’s office is located far from their homes, or when there are limited in-person visits.
The objectives of the research are as follows: “To contribute to understanding the role of patient portal messaging in multiple sclerosis (MS) care by evaluating its perceived value and usage among patients and clinicians, with the goal of identifying opportunities to enhance communication, improve care coordination, and better understand potential contributions to clinician burnout.”
Medical details and study results provided in MSAA’s published materials are for informational purposes only and are not to be considered as treatment advice or recommendations. Readers are encouraged to consult a healthcare professional before making any changes to their current treatment regimen.
References
- Bar-Or A, Oh J, Dufek M, et al. Fenebrutinib maintains low disease activity in relapsing multiple sclerosis: results from the FENopta open-label extension. PLA-A5. CMSC 2025 Annual Meeting. May 28-31, 2025. Phoenix, AZ.
- Vermersch P, Granziera C, Mao-Drayer Y, et al. Safety and efficacy of frexalimab from the phase 2 open-label extension in participants with relapsing multiple sclerosis: two-year results. PLA-A6. CMSC 2025 Annual Meeting. May 28-31, 2025. Phoenix, AZ.
- Kline A. Assessing the role of patient portal messaging in multiple sclerosis care: patient preferences, usage, and potential implications for clinician burnout. LBA03. CMSC 2025 Annual Meeting. May 28-31, 2025. Phoenix, AZ.