Umeå University, Sweden: Intrathecal monoclonal antibody therapy

Intrathecal monoclonal antibody therapy and cerebral microdialysis in progressive multiple sclerosis

Principal Investigator: Anders Svenningsson, M.D., Ph.D.
Institution: Umeå University
Country: Sweden
Amount Awarded: €74,800

Small clusters of immune cells called B cells are commonly found within the brains of people with progressive MS, which points to the presence of hidden and potentially damaging immune activity. Rituximab is an agent that eliminates B cells. Trials using rituximab in progressive MS so far have not been successful, possibly because rituximab is unable to access these particular B cell clusters. This team is administering rituximab directly into the spinal fluid (intrathecally). In an ongoing trial they have been treating people with progressive MS with this method, with some success. Now, while continuing to test this treatment, the team will sample immune messenger chemicals inside the brain using a device called a microdialysis catheter. They plan to insert this device in 20 people to better determine outcomes of the treatment and, for the first time, attempt to monitor immune activity inside the brains of people with progressive MS.

What does this mean for people living with progressive MS?

This study can answer the question of whether there is ongoing inflammation in the brains of people with progressive MS, and whether rituximab has potential as a treatment for progression.

Project Update

Status: Complete

The team has enrolled 20 patients into a trial testing intrathecal (IT) delivery of rituximab (RTX) and the first results of safety and feasibility will be available in the near future. Preliminary published results indicate that  even minute quantities of RTX delivered IT would deplete peripheral B lymphocytes almost immediately and has provided valuable information regarding the pharmacokinetics of IT injections.

Principal Investigator: Anders Svenningsson

Image of Anders SvenningssonAnders Svenningsson, MD, PhD, earned his medical degree at the University of Gothenburg in Sweden and his doctoral degree at the same University on the subject of immunological changes in the cerebrospinal fluid in MS. He completed postdoctoral training at the Karolinska Institute in the group of Professor Tomas Olsson with further focus on the immunopathology of MS. He became a board certified Neurologist 1998 and is one of the leading persons in the field of MS treatment in Sweden, holding regular teaching courses on the topic for Swedish neurology residents. Dr. Svenningsson was chair of the Swedish MS Association 2011 – 2013 and is presently chair of the Swedish Association of Neurology. The main focus of Dr. Svenningsson’s research today is to develop new efficient treatment protocols in MS in both the inflammatory phase and the progressive phase of the disease.

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