Promising data suggests a new multiple sclerosis treatment could stop or reverse symptoms

An MRI image of the brain showing multiple sclerosis plaques

An MRI image of the brain showing multiple sclerosis plaques
Picture: Getty (Getty Images)

Early clinical data looks promising for an experimental treatment for multiple sclerosis. The treatment, which targets a virus closely related to MS called Epstein-Barr virus, has been shown to be safe and possibly effective in stopping the progression of symptoms in some patients. But it will take a lot more data to know if this approach can represent a real leap forward in the management of the debilitating condition.

Multiple sclerosis is caused by an overactive immune system that attacks our nervous system’s myelin sheath, a protective layer around nerve cells that also allows them to communicate more effectively with each other. Symptoms can vary greatly from person to person, with the majority experiencing intermittent flare-ups of the disease. But a substantial percentage will initially or over time experience progressive worsening of the disease. Symptoms of MS can include muscle weakness, difficulty walking and ultimately permanent loss of motor function.

Current treatments can manage the severity of symptoms in these progressive cases but do not change the trajectory of the disease. Biotech company Atara Biotherapeutics hopes its experimental treatment, codenamed ATA188, can accomplish just that. ATA188 is derived from donor T cells that have been trained to target other cells infected with Epstein-Barr virus, a herpes virus that has become well associated with MS.

Most people get EBV at some point in their lives, but few experience acute symptoms before the virus becomes dormant in the body (when they do, it’s commonly called mono). However, evidence has accumulated that EBV infection can trigger the chain of events that leads to MS in a rare and unlucky few. Earlier this year, a major study found perhaps the strongest evidence to date that EBV could indeed be the primary cause of MS.

In some cases of MS, it is theorized that chronic EBV infection continues to wreak havoc on the body, perhaps by trick antibodies by attacking a protein found in our myelin sheath that resembles a protein found on the virus. By using ATA188 to treat these chronic infections, the company hopes it can slow or even reverse symptoms in people with progressive MS. And so far, this theory still seems to have solid foundations.

Like reported by LiveScience this week, the latest Phase I data on ATA188, presented last month by the company to its investors, has provided very encouraging results so far. The treatment appears to be safe and well tolerated. And in 20 of 24 patients treated with ATA188, results suggested it either stopped or reversed the progression of symptoms, up to two years later. In these cases, there is even evidence that their nerve cells are scavenging myelin, which is something that is rarely seen in the natural course of the disease.

Of course, phase I trials are mainly about showing that an experimental treatment is safe.not prove that it works. And these latest results have not yet been peer-reviewed, meaning they should be taken with even more caution at this time. It is also possible that at least some cases of progressive MS are not helped by treatment of EBV infection, as other underlying factors may be involved. But if ATA188 continues to show good results, it could prove to be the first treatment capable of halting or reversing the decline of patients with progressive MS – a “transformative” therapy in Atara’s words..

The company has already moved forward with a larger Phase II trial of the treatment, with interim data expected to be available in the second quarter of 2022.

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