Ibudilast

Abstract

While the armamentarium to treat relapsing-remitting multiple sclerosis MS is ever-expanding, the choice of drugs to treat progressive forms of the disease remains limited. Although (ongoing) inflammation may play a role in neurodegeneration, other mechanisms are likely to contribute to it, and there is a need to identify drugs with a neuroprotective mode of action. Ibudilast is a drug that has previously been suggested to have a neuroprotective effect in relapsing-remitting MS1: ibudilast (60 mg) did not reduce the MRI activity or the relapse rate but reduced brain volume loss accumulation by 34%. The Safety, Tolerability and Activity Study of Ibudilast in Subjects With Progressive Multiple Sclerosis (SPRINT-MS) trial2 was a multicenter study sponsored by the NIH that included patients up to 65 years of age with primary and secondary progressive MS. The trial showed that ibudilast (100 mg) reduced brain volume loss by 48% over 2 years.