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ECTRIMS 2023 | Refining extended dosing and exploring wearing-off biomarkers

Alyssa Toorop, MD, PhD, Amsterdam University Medical Centers, Amsterdam, The Netherlands, discusses the future of the NEXT-MS trial, which will continue with an amended protocol. This amended protocol focuses on extending treatment intervals to a minimum of six weeks, with personalized dosing adjustments based on drug concentration targets. They anticipate that 30-40% of participants will be able to surpass this six-week threshold, aiming to lessen treatment-related strains, decrease healthcare costs, and potentially reduce progressive multifocal leukoencephalopathy (PML) risk. Another pioneering element of the SUPER NEXT-MS study involves the development of a pharmacokinetic model, factoring in drug concentration and patient BMI for a more accurate estimation of treatment intervals. To better understand the biological underpinnings of wearing-off symptoms, the study also investigates the potential associations with biomarkers, like neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP). This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2023 in Milan, Italy.

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The NEXT-MS trial was funded by the Dutch MS Research Foundation, the Brain Foundation Netherlands, and Innovation Funds Healthcare insurers. The funding sources had no involvement in the execution of the study.