Neurology

Anti–tumor necrosis factor (TNF) agents, widely used in rheumatology and gastroenterology, carry some safety risks. While the risk of infection or malignancy are common concerns, neurological complications, while rare, are also possible.

During the fourth congress of the European Academy of Neurology, held in Lisbon, Portugal, from June 16 to 19, researchers reported on CinnaGen’s biosimilar interferon beta 1A drug, CinnoVex, in treating multiple sclerosis (MS).

Ever since biosimilars arrived in the United States in 2015 with the launch of Sandoz’s Zarxio, a biosimilar of Amgen’s Neupogen, reference product manufacturers and biosimilar manufacturers have locked horns on pricing, patents and access policies—and the competition remains fierce. Now the industry is preparing for the next wave of biosimilars, which will launch from 2020 to 2030. At least 19 branded biologics, which grossed more than $40 billion worldwide in 2017, have around 80 biosimilars from 39 manufacturers under development in the United States and European Union.

While rituximab is frequently used off-label to treat relapsing-remitting multiple sclerosis (MS), emerging evidence suggests that patients with progressive MS may also benefit from treatment with rituximab.

Antibodies that deplete B cells, including rituximab, have demonstrated efficacy in the treatment of neurological conditions such as progressive multiple sclerosis and neuromyelitis optica spectrum disorder. The efficacy of these treatments hinges on adequate B-cell depletion, but there is a lack of standardization in treatment and monitoring protocols to guide clinical practice.

While systemic inflammation is a potential biological mechanism underlying both Parkinson disease (PD) and inflammatory bowel disease (IBD), clinical data on comorbid PD and IBD are few. In a new study published in JAMA Neurology, researchers report on a retrospective cohort study that assessed the incidence of PD among patients with IBD and sought to identify whether anti–tumor necrosis factor (anti-TNF) therapy for IBD alters the risk of PD.

Rituximab has been successfully used “off label” to treat diseases driven by B-cell dysregulation, but concerns remain about the safety of using rituximab or similar agents for long periods.

Rituximab (Rituxan) is more effective and has lower rates of discontinuation than other disease-modifying treatments in newly diagnosed patients with relapsing-remitting multiple sclerosis, according to a Swedish study published online in the January 8, 2018, issue of JAMA Neurology.

Rituximab, which is approved for the treatment of some cancers and inflammatory conditions, also holds significant promise for patients with neurological diseases.