AAN Annual Meeting Highlights: Sleep Quality, Migraine, COVID-19 Interferon Treatment and More

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The American Academy of Neurology Virtual Annual Meeting 2021 is ongoing from April 17 through 22, with literally hundreds of presentations. Here’s a peek at just some of them.

Treatment of Primary Brain Tumor Linked to Poor Sleep Quality

A retrospective study presented by researchers at MD Anderson Cancer Center, Wellsley College, and Harvard University evaluated treatment of primary brain tumor (PBT) and sleep disturbances. All of the patients in the study were referred to a sleep center and were tested by polysomnography. Most of the PTBs were diffuse astrocytic and oligodendroglial tumors (69%) and tumors located in the cerebral cortex (71%). Sleep disturbances were noted in 29% of patients before tumor diagnosis, and 93.5% after tumor treatment.

The authors noted that future prospective research should study “clinical data and quantitative sleep parameters in larger patient cohorts to elucidate the sleep-tumor connection, interventions to improve sleep and ultimately improve” quality of life in PBT patients.

Novartis’ Post-Hoc Data in the Phase III ASCLEPIOS Trial of Kesimpta

Novartis presented new post hoc data drawn from a pool of 833 patients in the Phase III ASCLEPIOS trial of Kesimpta (ofatumumab). The data confirmed the drug’s greater clinical efficacy and tolerability after it was approved by the European Medicines Agency (EMA) for relapsing forms of multiple sclerosis (RMS).

The primary endpoint was the annualized rate of relapse. Secondary endpoints evaluated magnetic resonance imaging (MRI) lesion activity. Kesimpa demonstrated a superior clinical profile compared to Sanofi’s Aubagio (teriflunomide), with a 51% to 59% higher decrease in relapse rate than Aubagio in part I and part II of the trial, respectively.

Lundbeck’s Vyepti’s Earlier Prevention of Migraine

Lundbeck announced new data from RELIEF, a parallel-group, double-blind, randomized, placebo-controlled trial of Vyepti when dosed within one to six hours of a moderate to severe migraine attack in people eligible for preventive treatment. The co-primary endpoints were time to freedom from headache pain and time to absence of the most bothersome symptom (MBS). The MBS options were photophobia (sensitivity to light), phonophobia (sensitivity to sound), and nausea.

Lundbeck presented two abstracts. The first described patients who received a 100-mg infusion of Vyepti. The patients hit the co-primary endpoints earlier than placebo, with a median time to headache pain-free of four hours compared to nine hours for placebo, and a median time of two hours to the absence of their MBS compared to three hours with placebo.

Biohaven Pharmaceutical presented on Nurtec for Migraine

Biohaven presented 22 abstracts and three oral presentations. They presented new data analysis of Nurtec ODT (rimegepant) for acute treatment for migraine, in addition to multiple pipeline assets including intranasal zavegepant for acute migraine, troriluzole for treatment of spinocerebellar ataxia (SCA), and verdiperstat for multiple system atrophy (MSA).

“The presentation of more than 20 abstracts across therapeutic areas at AAN 2021 demonstrates Biohaven’s continued commitment to neuroscience research excellence across all of the company’s clinical candidates,” said Elyse Stock, Biohaven’s chief medical officer. “We are excited about these analyses reporting on the efficacy and safety of Nurtec ODT for the acute and preventive treatment of migraine, as well as advancements in pipeline assets including zavegepant, troriluzole, and verdiperstat. Nurtec ODT has the potential to provide a unified approach for the acute and preventive treatment of migraine and we look forward to the U.S. Food and Drug Administration’s decision for this dual indication later this quarter.”

Interferon Decreases Risk for Severe COVID-19 in MS Patients

Italian researchers from the University of Genoa, University Hospital San Luigi, University of Bari and numerous others presented a study on the use of interferon in multiple sclerosis (MS) patients. They found that using interferon might reduce the risk of severe COVID-19 in these patients, while anti-CD20 therapies may increase the risk. The data was collected from March 2020 in MS patients with suspected or confirmed COVID-19. They increased routine serologic testing, and also collected data on asymptomatic patients with MS and COVID-19. It involved 902 patients with MS, including 298 with confirmed COVID-19 and 604 with suspected COVID-19. About 4% were asymptomatic.

Eight of 95 patients who received anti-CD20 therapies either ended up in intensive care or died. About 5% of patients with MS who received treatments other than anti-CD20 and interferon were also either admitted to the ICU or died. Of the 37 asymptomatic patients, seven received interferon, one with anti-CD20, and 29 with other drugs. Treatment with interferon was linked to decreased risk of severe COVID-19 compared to treatment with dimethyl fumarate, while treatment with anti-CD20 therapies including ocrelizumab or rituximab were linked with an increased risk of severe COVID-19.