Today is TriMS day


The seventh meeting will take place on Thursday 25 May 2023 on the theme BTK inhibitors: an exciting new era in MS therapy.

It seems like the organisers don’t want you there, health care pros only….it’s the rules Pharama has the maketeers that can talk to you and the neuros and the sciency lot that provide info to your neuros

This conference will discuss the following topics and will feature the latest data and clinical insights on the topic.

  • BTK inhibition as a potential therapeutic target in MS
  • The prospects for long term administration in MS
  • Clinical development of BTK inhibitors in MS
  • Learnings from a safety perspective
  • Positioning in the treatment pathway

Now looking forward to

Want to learn about BTK it is going to be 2024 the year of the BTK as the first big trials finish in 2023.

They are going to put liver monitoring into the care pathway as we have seenliver problems with some of them in trials and manybe a matter of time for the others. Remember this class o compounds is already in clinical use and some MS drugs also raise liver enzymes and liver function has to be screened.

Brown is BTK expression of HLA-DR a marker of antigen presenting cells (in this case liver macrophages), CD3e is a T cell marker present in lymph nodes but not in liver, in lymph node BTK is on B cells, but on dendtric cells (in paracortex) and macrophages.

Starts with a Meet the expert session. The role of microglia in MS and other neurodegenerative diseases Heinz Wiendl, Germany ,Jiwon Oh, Canada, Jacqueline Nicholas, USA, Martin Weber,

You can get the info from these reviews all free if interested

Krämer J, Bar-Or A, Turner TJ, Wiendl H.Nat Rev Neurol. 2023 May;19(5):289-304.Bruton tyrosine kinase inhibitors for multiple sclerosis.

Furman MJ, Meuth SG, Albrecht P, Dietrich M, Blum H, Mares J, Milo R, Hartung HP.Front Immunol. 2023 Mar 9;14:1129906.B cell targeted therapies in inflammatory autoimmune disease of the central nervous system.

Rozkiewicz D, Hermanowicz JM, Kwiatkowska I, Krupa A, Pawlak D.Molecules. 2023 Mar 6;28(5):2400. Bruton’s Tyrosine Kinase Inhibitors (BTKIs): Review of Preclinical Studies and Evaluation of Clinical Trials.

Behind a paywall

Dybowski S, Torke S, Weber MS.JAMA Neurol. 2023 Apr 1;80(4):404-414.Targeting B Cells and Microglia in Multiple Sclerosis With Bruton Tyrosine Kinase Inhibitors: A Review.

I’ll have my “Fact Checkers” on the ready to look for BSH1 answers.

All of the agents are in trial for RRMS EVO- and TOL- will report first with FEN- and REM- brutinib later and then there are two in progressive MS trials.

Today the interesting element is

POSITIONING in the Treatment pathway.

The question we need answering is this….Why do we need them? and Are they Good Enough?

For RRMS it is a question of efficacy and side-effects and convenience are they any better than what you have now….based on some phase II data….not really so I’m not so sure, but hope so. Otherwise we are going to see a lot of drugs reps thrown from tall pharma buildings by their bosses.

Are they going to be comfort drugs used say after your MS is controlled with and IRT and then you have the comfort of taking treatment rather than nothing….But that’s another trial that would need to be done.

The Big Question is what happens in Progressive MS. Is a CNS penetrant BTK inhibitor going to inhibit microglial function to inhibit progression. Is it going to inhibit microglia to stop them clearing up damage to allow repair. What is the balance of these effects going to be.

We wont’t hear the answer to this at TRIMS today

About the author


Add comment



Recent Posts

Recent Comments