Key updates in disease-modifying therapies for relapsing-remitting multiple sclerosis (RRMS) from the 2025 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) forum are reported by Dr Pavan Bhargava of Johns Hopkins Hospital in Baltimore, Maryland.
First, Dr Bhargava highlights findings on the effects of a 6-month modified Atkins diet on patients with RRMS. The study showed ketogenic diets can modulate immunity in MS by reprogramming cell metabolism and promoting anti-inflammatory responses.
Next, he reviews two studies on B-cell depletion in underrepresented minority MS populations. The CHIMES study examines the effectiveness of ocrelizumab in Black and Hispanic MS patients. After 24 weeks, the trial showed MRI outcomes comparable to the pivotal phase 3 ocrelizumab OPERA trial, as well as a steeper decline in neurofilament levels, indicating greater inflammation reduction. The OLIKOS study demonstrated that switching to subcutaneous ofatumumab maintained efficacy in minority groups similar to MRI outcomes in White participants.
Lastly, Dr Bhargava discusses the Breakfree-2 trial that examines a novel mode of treatment for patients with RRMS, which is chimeric antigen receptor (CAR) T-cells to target CD19. Early indicators suggest this therapy may be safe and generally well tolerated, but further studies are warrented to assess the efficacy of these interventions.
