cfs since 1998
Senior Member
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Synopsis: An Australian committee has selected four drugs to recommend for clinical trials of anti-Epstein-Barr virus treatment for MS. The drugs are famciclovir ("Famvir") (which slightly edged out valacyclovir/"Valtrex"), tenofovir alafenamide ("Vemlidy"), maribavir ("Livtencity"), and spironolactone ("Aldactone").
The committee supports Phase III clinical trials of these drugs for MS, but notes, "the concept of using anti-EBV drugs to treat MS is predicated on the assumption that EBV replication or persistence of latently infected auto-reactive B cells contributes to persistent neuroinflammation in people with MS. There is currently no evidence to support this hypothesis."
Abstract
Background: Epstein-Barr virus (EBV) is implicated as a necessary factor in the development of multiple sclerosis (MS) and may also be a driver of disease activity. Although it is not clear whether ongoing viral replication is the driver for MS pathology, MS researchers have considered the prospect of using drugs with potential efficacy against EBV in the treatment of MS. We have undertaken scientific and lived experience expert panel reviews to shortlist existing licensed therapies that could be used in later-stage clinical trials in MS.
Methods: A list of therapies with anti-EBV effects was developed from existing reviews. A detailed review of pre-clinical and clinical data was undertaken to assess these candidates for potential usefulness and possible harm in MS. A 'drug-CV' and a plain language version focusing on tolerability aspects was created for each candidate. We used validated criteria to score each candidate with an international scientific panel and people living with MS.
Results: A preliminary list of 11 drug candidates was generated. Following review by the scientific and lived experience expert panels, six yielded the same highest score. A further review by the expert panel shortlisted four drugs (famciclovir, tenofovir alafenamide, maribavir and spironolactone) deemed to have the best balance of efficacy, safety and tolerability for use in MS.
Conclusions: Scientific and lived experience expert panel review of anti-EBV therapies selected four candidates with evidence for efficacy against EBV and acceptable safety and tolerability for potential use in phase III clinical trials for MS.
~~~
News article:
https://www.msaustralia.org.au/news/could-drugs-that-target-ebv-treat-ms/
Research paper:
https://pubmed.ncbi.nlm.nih.gov/39792343/
Full text:
https://link.springer.com/epdf/10.1007/s40263-024-01153-5?sharing_token=8cDhP4lHZwLRZtm309UbZfe4RwlQNchNByi7wbcMAY7ZAsqZMBszNjUT8Eu1nLwnj3XEAnUZIx8llEhWcUld8b2yQfxwYAJSIjr_paXfSPfkCDUbYRMPP2kYf8yHkh0LHiv6-ss5Lc2xFDPXA_pOnMDe4vkyv85Got47l2PIKPg=
The committee supports Phase III clinical trials of these drugs for MS, but notes, "the concept of using anti-EBV drugs to treat MS is predicated on the assumption that EBV replication or persistence of latently infected auto-reactive B cells contributes to persistent neuroinflammation in people with MS. There is currently no evidence to support this hypothesis."
Abstract
Background: Epstein-Barr virus (EBV) is implicated as a necessary factor in the development of multiple sclerosis (MS) and may also be a driver of disease activity. Although it is not clear whether ongoing viral replication is the driver for MS pathology, MS researchers have considered the prospect of using drugs with potential efficacy against EBV in the treatment of MS. We have undertaken scientific and lived experience expert panel reviews to shortlist existing licensed therapies that could be used in later-stage clinical trials in MS.
Methods: A list of therapies with anti-EBV effects was developed from existing reviews. A detailed review of pre-clinical and clinical data was undertaken to assess these candidates for potential usefulness and possible harm in MS. A 'drug-CV' and a plain language version focusing on tolerability aspects was created for each candidate. We used validated criteria to score each candidate with an international scientific panel and people living with MS.
Results: A preliminary list of 11 drug candidates was generated. Following review by the scientific and lived experience expert panels, six yielded the same highest score. A further review by the expert panel shortlisted four drugs (famciclovir, tenofovir alafenamide, maribavir and spironolactone) deemed to have the best balance of efficacy, safety and tolerability for use in MS.
Conclusions: Scientific and lived experience expert panel review of anti-EBV therapies selected four candidates with evidence for efficacy against EBV and acceptable safety and tolerability for potential use in phase III clinical trials for MS.
~~~
News article:
https://www.msaustralia.org.au/news/could-drugs-that-target-ebv-treat-ms/
Research paper:
https://pubmed.ncbi.nlm.nih.gov/39792343/
Full text:
https://link.springer.com/epdf/10.1007/s40263-024-01153-5?sharing_token=8cDhP4lHZwLRZtm309UbZfe4RwlQNchNByi7wbcMAY7ZAsqZMBszNjUT8Eu1nLwnj3XEAnUZIx8llEhWcUld8b2yQfxwYAJSIjr_paXfSPfkCDUbYRMPP2kYf8yHkh0LHiv6-ss5Lc2xFDPXA_pOnMDe4vkyv85Got47l2PIKPg=