Medical Bulletin 30/December/2022

TG Therapeutics recently announced the U.S. Food and Drug Administration (FDA) has approved BRIUMVI (ublituximab-xiiy), for the treatment of relapsing forms of multiple sclerosis (RMS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.

Approval was granted for this indication based on data from the ULTIMATE I & II Phase 3 trials, which demonstrated superiority over teriflunomide in significantly reducing the annualized relapse rate (ARR, the primary endpoint), the number of T1 Gd-enhancing lesions and the number of new or enlarging T2 lesions. Results from the ULTIMATE I & II trials were recently published in August 2022 in The New England Journal of Medicine.

Reference:

BRIUMVI prescribing information,TG Therapeutics NY

STeinman L et al,ublituximab versus teriflunomide in relapsing multiple sclerosis,10.1056/NEJMoa2201904

DATA on file,TG Therapeutics NY

Exposure to nature may reduce the risk of neurodegenerative disease-led hospitalization in elderly: JAMA Study

The findings of a recent cohort study published in JAMA Network Open suggest that some natural environments are associated with a decreased risk of ADRD and PD hospitalization. Neurological disorders are the leading cause of disability and the second leading cause of death worldwide. The most prevalent neurological diseases in the US are Alzheimer's disease and related dementias (ADRD) and Parkinson's disease (PD).

The researchers wanted to evaluate associations of natural environments with hospital admissions for Alzheimer's disease and related dementias (ADRD) and Parkinson's disease (PD) among older adults in the US.

Reference:

Jochem O. Klompmaker et al, JAMA Netw Open. 2022;5(12):e2247664. doi:10.1001/jamanetworkopen.2022.47664

Nerve pathway for good and bad feelings identified

Scientists in Japan have identified a nerve pathway involved in the processing of rewarding and distressing stimuli and situations in mice. The new pathway, originating in a bundle of brain stem nerve fibres called the median raphe nucleus, acts in opposition to a previously identified reward/aversion pathway that originates in the nearby dorsal raphe nucleus.

Previous studies had already revealed that activating serotonin-producing nerve fibres from the dorsal raphe nucleus in the brain stem of mice leads to the pleasurable feeling associated with reward. However, selective serotonin reuptake inhibitors (SSRIs), antidepressant drugs that increase serotonin levels in the brain, fail to exert clear feelings of reward and to treat the loss of ability to feel pleasure associated with depression. This suggests that there are other serotonin-producing nerve pathways in the brain associated with the feelings of reward and aversion.

Reference:

Yu Ohmura et al,Median raphe serotonergic neurons projecting to the interpeduncular nucleus control preference and aversion,Nature Communications,DOI

10.1038/s41467-022-35346-7