Vidofludimus calcium linked to fatigue reduction, may have long-term effect in MS

Key takeaways:

• A post hoc analysis indicates VidoCa administration could help prevent long-term fatigue.
• The drug’s antiviral, anti-inflammatory and neuroprotective effects suggest it as a promising treatment for MS.

WEST PALM BEACH, Fla. — Oral administration of vidofludimus calcium reduced fatigue over 14 days compared with placebo and may have a long-term positive effect in multiple sclerosis, according to a poster presented at ACTRIMS 2024.

“Our research aimed to identify the potential triggers of fatigue in MS patients, because the underlying pathogenesis of this very common, but extremely debilitating symptom remains unclear,” Daniel Vitt, PhD, CEO, president and director of Immunic Therapeutics, a German biotechnology firm, told Healio. “We thereby investigated if Epstein-Barr virus infection and reactivation, known to induce fatigue, could be a potential driver.”

Vitt and colleagues sought to investigate whether vidofludimus calcium (VidoCa) — an investigational, oral selective dihydroorotate dehydrogenase inhibitor — may reduce fatigue in MS due to its antiviral and antiinflammatory potential, as previously demonstrated for post-COVID-19 symptoms (PCS), as well as to prevent reactivation of Epstein Barr virus (EBV).

They conducted a phase 2 CALVID-1 clinical trial, in which 27 participants who tested positive for COVID-19 were randomized to receive placebo or 45 mg VidoCa for 14 days with both groups receiving standard-of-care treatment. All responded to a post hoc questionnaire sent to the blinded investigators in three high enroller sites.

According to results, 80% of participants given placebo reported fatigue compared with 50% of those administered 45 mg VidoCa. Fatigue decreased in both treatment groups in the next 9 to 17 weeks to 33% in the placebo cohort and 17% for those given VidoCa.

Analysis of antiviral activity of VidoCa further showed a dose-dependent reduction of lytic EBV reactivation in B cells as well as reduced lytic EBV production in Akata cells.

Further, in post hoc analysis of PCS symptoms, Vitt and colleagues noted a potential contribution of VidoCa to the prevention of long-term fatigue, one of the most common post-COVID-19 symptoms.

“Our drug candidate has already shown the ability to prevent reactivation of Epstein-Barr virus in our clinical trials and may therefore contribute to the reduction of fatigue in MS,” Vitt told Healio. “Overall, the drug’s combined antiviral, anti-inflammatory and neuroprotective effects suggest it as a promising treatment option.”