Therapeutic Hookworm Explored for Relapsing Multiple Sclerosis
No effect seen for hookworm versus placebo on number of new/enlarging/enhancing lesions
TUESDAY, June 16, 2020 (HealthDay News) -- For patients with relapsing multiple sclerosis (MS), treatment with hookworm appears to be safe, but it did not reduce the number of new/enlarging/enhancing lesions on brain magnetic resonance imaging (MRI) at month 9, according to a study published online June 15 in JAMA Neurology.
Radu Tanasescu, M.D., Ph.D., from the University of Nottingham in the United Kingdom, and colleagues conducted a double-blind randomized trial involving patients aged 18 to 61 years with relapsing MS without disease-modifying treatment. Seventy-one patients were recruited and randomly assigned to receive 25 Necator americanus larvae transcutaneously or placebo (35 and 36 patients, respectively); 66 patients completed the trial.
The researchers found no significant difference between the groups in the median cumulative number of new/enlarging/enhancing lesions (154 and 164 in the hookworm and placebo groups, respectively). In the hookworm group, the percentage of CD4+CD25highCD127negT regulatory cells increased at month 9 (4.4 versus 3.9 percent). None of the patients withdrew due to adverse effects. No between-group differences were seen in adverse events, but there were more reports of application-site skin discomfort in the hookworm group (82 versus 28 percent). Five and 11 relapses were observed in the hookworm and placebo groups, respectively (14.3 versus 30.6 percent).
"The trial can inform future trials with therapeutic hookworm, which may include different MRI outcome measures (e.g., the proportion of patients with no detectable disease activity on MRI), interval booster redosing, higher numbers of larvae, or longer treatment periods, allowing assessment of the effects on disease progression," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.