Clemastine Repairs Damage In Multiple Sclerosis

Research Summary: MWF of the corpus callosum is a robust measure of remyelination: Results from the ReBUILD trial

Remyelination or myelin repair is the next big step in the treatment of multiple sclerosis.  Currently, there are no approved therapies that can repair damage caused to the myelin sheath during multiple sclerosis.  As well as finding compounds that have the potential to promote remyelination, research is also focused on how the effectiveness of these prospective therapies will be measured.

Today, we are going to summarise a study that has looked at both of these aspects of remyelination.

What?

The study looked at imaging results from the ReBUILD trial, as a way of assessing how useful this data is for determining the effectiveness of clemastine to promote remyelination in people living with multiple sclerosis.

Who?

This research was conducted by a team at University of California, San Francisco (UCSF) in the USA.

Where?

The article was published in PNAS.  The article is currently open-access and can be viewed here.

When?

The study was published in May, 2023.

BACKGROUND #1:  While a number of therapies are available that help slow the progression of multiple sclerosis, there are no approved treatments to repair damaged myelin.  This is a key focus of current research, as it may help reverse some of the disability and symptoms experienced by people living with MS.

BACKGROUND #2:  Clemastine was identified several years ago as a compound that has the potential to repair myelin.  Our summary of this original discovery can be read here.

BACKGROUND #3:  The most appropriate way to measure the success and effectiveness of remyelination therapies is yet to be determined.  Having an accurate and reliable method for this is critical, as we will start to see an increasing number of clinical trials for remyelination therapies being undertaken.

BACKGROUND #4:  A small, early-phase clinical trial is now underway at the University of Cambridge, which is testing the remyelination potential of clemastine and metformin in people living with relapsing-remitting multiple sclerosis.  A recent video update on this trial can be viewed here.

FINDING #1: This study provides further data highlighting the potential of clemastine to promote remyelination in people living with relapsing-remitting multiple sclerosis.

FINDING #2:  Importantly, the research also provides evidence for the use of an MRI imaging technique to measure myelin repair in trials of novel remyelination therapies.

There is a lot of excitement around any possible advancements in remyelination, as well as a (completely understandable) desire for these therapies to be fast-tracked.  This study has provided some very interesting new information, but there are still some questions that need to be answered.

THOUGHT #1:  While having more evidence regarding clemastine being able to repair myelin is obviously promising, I think it is the imaging data presented in this study that is the most significant.  Recently, I have been fortunate enough to participate in a number of discussions with leading scientists from around the world that are at the forefront of remyelination research.  While the consensus from these discussions has been that finding the most appropriate and accurate tools for measuring outcomes in clinical trials for myelin repair is incredibly important, at this point in time, we don’t have a definitive answer on what these may be.  Considering this, the findings in this recent UCSF study about the ability of MRI imaging to play a role in this area are noteworthy.

In conclusion, this is another exciting step forward in the pursuit of remyelination.  We will continue to closely follow all of the studies on this topic and provide updates as soon as they become available.  As always, if you have questions, please don’t hesitate to post them under the story on any of our social media channels.

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