ECTRIMS: Novartis' Mayzent delays wheelchair use by 4-plus years for MS patients

Novartis is working to change doctors’ “psychology” around the treatment of secondary progressive multiple sclerosis (SPMS). And new disability data for its drug, Mayzent, should help its case.

On average, patients taking Mayzent went more than four years longer than those taking a placebo before needing to rely on a wheelchair, according to a post hoc analysis presented on Thursday at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) annual congress in Stockholm.

And that’s a big deal, especially considering the “severe disability” that SPMS patients typically have, Novartis Pharmaceuticals global program head Norman Putzki, M.D., Ph,D, said. Half the patients in the phase 3 Expand study, from which Novartis drew the new analysis, needed a cane or crutch to walk 50 to 100 meters, he said.

The “overall burden of the disease and limitation on their daily activities is really substantial in SPMS,” Putzki said, adding that “when you reduce disease progression or prolong time to wheelchair … it really underlines the meaningfulness of the effects you can demonstrate.”

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Prior to Mayzent’s FDA approval in March, Novartis showed that the drug could drive a significant reduction in the risk of a patient's disability worsening—between 14% and 20% compared with placebo at three months of treatment for nonrelapsing patients, and between 29% and 33% at the six-month mark. And the latest analysis provides “a really nice addition to the overall reduction of disability progression in these SPMS patients,” Putzki said. 

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For Novartis, though, the challenge around Mayzent lies in getting doctors to identify and treat SPMS at all. Up to 80% of patients with relapsing-remitting MS go on to develop SPMS, but identifying it “early, rather than ignoring it, is a big clinical challenge,” Putzki noted.

In the past, without treatment that could change the course of SPMS, “there was a certain psychology” that doctors would rather avoid the conversation with their patients altogether.

Now, though, with Mayzent, “there is an additional option to tackle the disease at that stage, rather than just saying, ‘You are at the stage of the disease where I can’t do anything else,’” Putzki said.

Novartis is counting on doctors to pivot to that option, particularly as copycats to MS therapy Gilenya advance. Vantage analysts have predicted that Mayzent's 2024 sales could reach $1.30 billion.