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Translating LINGO

Hypotheses about the reasons for Biogen's LINGO miss in MS

Biogen Inc. isn't talking yet about why its anti-LINGO mAb failed a Phase II trial in the high-priority indication of multiple sclerosis, but translational researchers in the field have some ideas about knowledge gaps that may have contributed to the miss.

These include open questions about the time points at which it would be best to inhibit LINGO in the course of a flare or the course of disease, how central a role LINGO plays in remyelination, how much antibody needs to get across the blood-brain barrier, and the best ways to assess whether inhibiting LINGO is having the desired effect.

Answers to some of these questions may come when the company reports detailed data from the Phase II SYNERGY trial of opicinumab (BIIB033) at the September congress of the European Committee for Treatment and Research in Multiple Sclerosis. Other answers may have to wait for future trials.

Opicinumab is intended to treat an aspect of MS that no approved drugs can tackle by repairing damage to myelin sheaths. Damage to myelin leads to axon loss and neuronal death if the body cannot repair them in time.

"In progressive MS nerves die; that's why people get disabled. It's important to put myelin

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