Clinicians at Emory University School of Medicine are taking another look at immunosuppressants as a potential treatment for the disease.
The anti-rejection drugs, which include Genentech’s CellCept (mycophenolate mofetil) and Astella’s Prograf (tacrolimus), are the same medicines prescribed to people with ALS participating in the ongoing clinical trial of Neuralstem’s potential stem cell therapy for ALS.
The approach stems from one participant, known as “patient 11”, who appears to benefit from the transplantation procedure.
Suppress ALS? Some clinicians suspect that one person with ALS may appear to benefit from Neuralstem's stem cell-based treatment strategy because of anti-rejection medicines.
This benefit, however, according to Emory University School of Medicine’s Christina Fournier MD, may instead be due to the anti-rejection medicines. The reason, according to Fournier, is that this improvement appears to occur too rapidly to be explained by a potential stem cell treatment.
“We have to study this patient,” says Duke University School of Medicine’s Rick Bedlack MD PhD. “We have to figure out what in the world made him better."
A phase II clinical trial is to take place at Emory University School of Medicine, Massachusetts General Hospital and University of Massachusetts Medical Center. 30 people with ALS are expected to participate.
The multi-drug regimen includes intravenous injections of Novartis’ Simulect (basiliximab) and methylprednisolone during the first week. Decreasing doses of prednisone during the first month. And, Genentech’s CellCept and Astellas’ Prograf for 6 months.
“We might not understand how it works,” says Fournier. “So, we don’t want to change it.”
The study aims to identify another person with ALS that may also benefit from these medicines in hopes to determine why “patient 11” may benefit due to this treatment strategy.
These anti-rejection medicines, however, according to phase I results, are not tolerated by some people with ALS.
The phase II clinical trial is now ongoing. Initial results are expected sometime in 2015.
To learn more about potential immunotherapies for people with ALS including immunomodulators and immunosuppressants being tested for the disease, tune into our podcast with ALS TDI’s Steve Perrin PhD.