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Ibudilast

Other names: MN-166

Ibudilast is an experimental drug treatment for secondary and primary progressive MS. It is taken as a tablet twice daily.

Summary

Ibudilast for secondary progressive MS: Phase II

Ibudilast for primary progressive MS: Phase II

Ibudilast is an experimental drug treatment for secondary and primary progressive MS. It is taken as a tablet, twice daily.

  • ibudilast acts on a number of cell processes associated with nerve damage and myelin repair. Previous studies have suggested it may have a¬†neuroprotective effect
  • in a phase II study, ibudilast slowed down the loss of brain volume in people with progressive MS by almost one half compared to placebo

How does ibudilast work?

Ibudilast inhibits the enzyme phosphodiesterase. It reduces inflammation and acts on a number of biochemical processes in cells associated with nerve damage and myelin repair. Previous studies have suggested it may have a neuroprotective effect.

Ibudilast is used in Japan and Korea to treat asthma and some complications of stroke.

How is ibudilast taken?

Ibudilast is taken as a tablet, twice daily.

Ibudilast research

What are the results so far?

  • ibudilast compared to placebo in relapsing MS

In this phase II study, 297 people with relapsing MS took one of two doses of ibudilast or placebo for 12 months. The main measure of the study was the total number of active lesions seen on MRI. Secondary measures included relapse rate, EDSS, lesion volume and brain volume.

There was no difference between the two groups in the number of active lesions or relapse rate. However, compared to placebo, fewer people taking ibudilast showed signs of progression.

  • SPRINT-MS - ibudilast compared to placebo in progressive MS

SPRINT-MS was a phase II study designed to assess the effectiveness and safety of ibudilast in people with progressive MS. 255 people with secondary and primary progressive MS took either ibudilast or placebo as tablets twice daily for nearly two years. MRI was used to measure brain volume at the beginning and end of the study. Compared to placebo, ibudilast slowed down the loss of brain volume (brain atrophy) by 48%.

Loss of brain volume is linked to cognitive and physical disability in MS and is used as a marker for MS progression; slowing down the rate at which brain volume is lost indicates that ibudilast is slowing down progression in MS.

Another advanced MRI imaging technique also provided some evidence that ibudilast reduced further damage to myelin and nerve cells. Further analysis of the trial results is underway.

Side effects

In the SPRINT-MS study, the most common side effects associated with ibudilast included gastrointestinal problems such as nausea, diarrhoea and abdominal pain, as well as depression, rash and fatigue.

More references

  • Feng J, et al. Ibudilast, a nonselective phosphodiesterase inhibitor, regulates Th1/Th2 balance and NKT cell subset in multiple sclerosis. Multiple Sclerosis 2004;10(5):494-498. Summary
  • Barkhof F, et al. Ibudilast in relapsing-remitting multiple sclerosis: a neuroprotectant? Neurology 2010;74(13):1033-1040. Summary
  • Goodman AD, et al. Ibudilast for the treatment of multiple sclerosis. Expert Opin Investig Drugs. 2016 Oct;25(10):1231-7. Summary

Last updated: November 2017
Last reviewed: November 2017
This page will be reviewed within three years

More references

  • Feng J, et al. Ibudilast, a nonselective phosphodiesterase inhibitor, regulates Th1/Th2 balance and NKT cell subset in multiple sclerosis. Multiple Sclerosis 2004;10(5):494-498. Summary
  • Barkhof F, et al. Ibudilast in relapsing-remitting multiple sclerosis: a neuroprotectant? Neurology 2010;74(13):1033-1040. Summary
  • Goodman AD, et al. Ibudilast for the treatment of multiple sclerosis. Expert Opin Investig Drugs. 2016 Oct;25(10):1231-7. Summary

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