Memory B cells were a close second and didn’t get a look-in.
Fastforward a year and we have more of a focus on memory B cells. They are dropped in the blood following treatment and supports the hypothesis we and others created.
(OK I a guess it is ocrelizumab being licenced that is driving all this interest in B cells:-0)
This study looks in the CNS. In most countries, the CNS is out of bounds but the Scandinanvias are made of stern stuff and lumbar puncture studies are often done.
Memory B cells are generally the dominant subtype in the cerebrospoinal fluid and brain, but have the capacity to change into plasmablasts and plasma cells.This may reflect a maturation step due to seeing a target of interest but it may put us a step closer to thinking about progression of MS.
If we look at the data, In this study memory B cells are about 25-35% of cells in the blood but are about 75% of B cells in the spinal fluid. This wasn’t lower than other treatments and there was not a decrease in the intrathecal antibody. So maybe DMF is is not sufficiently active in the CNS.
it would be really good if Sanofi did one on teriflunomide so we can get the data there. I’ve seen a p
One would predict it is varied to reflect the variable efficacy and not that great and maybe if used second line it might be less varied, if ProfG is right about relative efficacy second line.
If fact I can say it won’t be that great based on the data from arthritis with leflunomide which is broken down to teriflunomide once injected
Wijesinghe H et al. BMS musculoskeletal Disorders 2017:18:310.
It says no effect on whole T or B cell populations but a modest depletion of memory B cells compared to highly active agent like rituximab which has marked impact on B cells and memory B cells
This is a hypothesis with teriflunomide, I’ld like to test. On a mean basis memory B’s will go do in absolute terms but it won’t be great
Gandoglia I et al.Teriflunomide treatment reduces B cells in patients with MS. Neurol Neuroimmunol Neuroinflamm. 2017; 4(6): e403.
But not sure we have enough people taking the drug.