Ublituximab

Preliminary total global full year 2025 revenue of approximately $616 million Preliminary BRIUMVI U.S. fourth quarter and full year 2025 net product revenue of approximately $182 million and $594 million, respectively Full Year 2026 target total global revenue of approximately $875-900 million, including BRIUMVI U.S. net product revenue of approximately $825-850 million NEW YORK, Jan. 13, 2026 (GLOBE NEWSWIRE) -- TG Therapeutics, Inc. (NASDAQ: TGTX) (the Company or TG Therapeutics), today announced preliminary U.S. net product revenue for BRIUMVI® for the fourth quarter and full year ended December 31, 2025 (unaudited), as well as 2026 financial guidance and development milestones, during a preannounced presentation at the 44th Annual J.P Morgan Healthcare Conference. An audio replay of the event, as well as the corresponding slide presentation, are available on the Investors and Media section of the TG corporate website at ir.tgtherapeutics.com/events. Michael S. Weiss, the Company’s Chairman and Chief Executive Officer stated, “BRIUMVI continued to deliver strong commercial performance in 2025, reinforcing our confidence in the multi-billion dollar opportunity for BRIUMVI. With significant market share capture since launch, we believe TG Therapeutics is well positioned to drive long-term revenue growth and cash flow. Additionally, our development programs for consolidated IV BRIUMVI dosing and self-administered subcutaneous form of BRIUMVI are expected to drive revenue acceleration over the short and mid-term if approved. In parallel, we plan to initiate multiple exploratory studies that could expand BRIUMVI beyond MS, providing an additional lever for growth and underscoring its potential as a ‘pipeline-in-a-product.’ We also remain excited about the potential of azer-cel, our allogeneic CAR-T in autoimmune indications, starting with progressive forms of MS. Taken together, we believe we are executing a strategy designed to deliver sustained growth and long-term value for patients and shareholders.” Preliminary Fourth Quarter and Full Year 2025 Updates (based on unaudited financial information) BRIUMVI U.S. net product revenue expected to be approximately $182 million and $594 million for the fourth quarter and full year of 2025, respectively Total global full year 2025 revenue of approximately $616 million Preliminary selected financial information presented in this release are unaudited, subject to financial closing procedures and adjustment, and provided as an approximation in advance of the Company's announcement of complete financial results 2026 Financial Guidance Full Year 2026 target total global revenue of approximately $875-900 million, including BRIUMVI U.S. net product revenue of approximately $825-850 million Full year 2026 target operating expense, defined as R&D and SG&A, of approximately $350 million excluding non-cash compensation, and approximately $100 million in expenses associated with the subcutaneous BRIUMVI inventory build and secondary manufacturer start-up costs 2026 Development Pipeline Anticipated Milestones Announce pivotal topline data for ENHANCE trial combining Day 1 and Day 15 doses of IV BRIUMVI mid-year 2026 Present preliminary Phase 1 azer-cel data in Progressive MS in the second half of 2026 Announce pivotal topline data for subcutaneous BRIUMVI (ublituximab) year-end 2026/1Q 2027 Commence registration-directed trial for BRIUMVI in an indication outside of MS Commence additional exploratory studies for BRIUMVI and azer-cel in autoimmune disease (outside MS) ABOUT BRIUMVI® (ublituximab-xiiy) 150 mg/6 mL Injection for IV BRIUMVI is a novel monoclonal antibody that targets a unique epitope on CD20-expressing B-cells. Targeting CD20 using monoclonal antibodies has proven to be an important therapeutic approach for the management of autoimmune disorders, such as RMS. BRIUMVI is uniquely designed to lack certain sugar molecules normally expressed on the antibody. Removal of these sugar molecules, a process called glycoengineering, allows for efficient B-cell depletion at low doses. BRIUMVI is indicated in the U.S. for the treatment of adults with RMS, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease and in several countries outside of the U.S. for the treatment of adult patients with RMS with active disease defined by clinical or imaging features. A list of authorized specialty distributors can be found at www.briumvi.com. IMPORTANT SAFETY INFORMATION Contraindications: BRIUMVI is contraindicated in patients with: Active Hepatitis B Virus infection A history of life-threatening infusion reaction to BRIUMVI WARNINGS AND PRECAUTIONS Infusion Reactions: BRIUMVI can cause infusion reactions, which can include pyrexia, chills, headache, influenza-like illness, tachycardia, nausea, throat irritation, erythema, and an anaphylactic reaction. In MS clinical trials, the incidence of infusion reactions in BRIUMVI-treated patients who received infusion reaction-limiting premedication prior to each infusion was 48%, with the highest incidence within 24 hours of the first infusion. 0.6% of BRIUMVI-treated patients experienced infusion reactions that were serious, some requiring hospitalization. Observe treated patients for infusion reactions during the infusion and for at least one hour after the completion of the first two infusions unless infusion reaction and/or hypersensitivity has been observed in association with the current or any prior infusion. Inform patients that infusion reactions can occur up to 24 hours after the infusion. Administer the recommended pre-medication to reduce the frequency and severity of infusion reactions. If life-threatening, stop the infusion immediately, permanently discontinue BRIUMVI, and administer appropriate supportive treatment. Less severe infusion reactions may involve temporarily stopping the infusion, reducing the infusion rate, and/or administering symptomatic treatment. Infections: Serious, life-threatening or fatal, bacterial and viral infections have been reported in BRIUMVI-treated patients. In MS clinical trials, the overall rate of infections in BRIUMVI-treated patients was 56% compared to 54% in teriflunomide-treated patients. The rate of serious infections was 5% compared to 3% respectively. There were 3 infection-related deaths in BRIUMVI-treated patients. The most common infections in BRIUMVI-treated patients included upper respiratory tract infection (45%) and urinary tract infection (10%). Delay BRIUMVI administration in patients with an active infection until the infection is resolved. Consider the potential for increased immunosuppressive effects when initiating BRIUMVI after immunosuppressive therapy or initiating an immunosuppressive therapy after BRIUMVI. Hepatitis B Virus (HBV) Reactivation: HBV reactivation occurred in an MS patient treated with BRIUMVI in clinical trials. Fulminant hepatitis, hepatic failure, and death caused by HBV reactivation have occurred in patients treated with anti-CD20 antibodies. Perform HBV screening in all patients before initiation of treatment with BRIUMVI. Do not start treatment with BRIUMVI in patients with active HBV confirmed by positive results for HB surface antigen (HBsAg) and anti-HB tests. For patients who are negative for HBsAg and positive for HB core antibody [HBcAb+] or are carriers of HBV [HBsAg+], consult a liver disease expert before starting and during treatment. Progressive Multifocal Leukoencephalopathy (PML): Although no cases of PML have occurred in BRIUMVI-treated MS patients, JC virus infection resulting in PML has been observed in patients treated with other anti-CD20 antibodies and other MS therapies. If PML is suspected, withhold BRIUMVI and perform an appropriate diagnostic evaluation. Typical symptoms associated with PML are diverse, progress over days to weeks, and include progressive weakness on one side of the body or clumsiness of limbs, disturbance of vision, and changes in thinking, memory, and orientation leading to confusion and personality changes. MRI findings may be apparent before clinical signs or symptoms; monitoring for signs consistent with PML may be useful. Further investigate suspicious findings to allow for an early diagnosis of PML, if present. Following discontinuation of another MS medication associated with PML, lower PML-related mortality and morbidity have been reported in patients who were initially asymptomatic at diagnosis compared to patients who had characteristic clinical signs and symptoms at diagnosis. If PML is confirmed, treatment with BRIUMVI should be discontinued. Vaccinations: Administer all immunizations according to immunization guidelines: for live or live-attenuated vaccines, at least 4 weeks and, whenever possible, at least 2 weeks prior to initiation of BRIUMVI for non-live vaccines. BRIUMVI may interfere with the effectiveness of non-live vaccines. The safety of immunization with live or live-attenuated vaccines during or following administration of BRIUMVI has not been studied. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Vaccination of Infants Born to Mothers Treated with BRIUMVI During Pregnancy: In infants of mothers exposed to BRIUMVI during pregnancy, assess B-cell counts prior to administration of live or live-attenuated vaccines as measured by CD19+ B-cells. Depletion of B-cells in these infants may increase the risks from live or live-attenuated vaccines. Inactivated or non-live vaccines may be administered prior to B-cell recovery. Assessment of vaccine immune responses, including consultation with a qualified specialist, should be considered to determine whether a protective immune response was mounted. Fetal Risk: Based on data from animal studies, BRIUMVI may cause fetal harm when administered to a pregnant woman. Transient peripheral B-cell depletion and lymphocytopenia have been reported in infants born to mothers exposed to other anti-CD20 B-cell depleting antibodies during pregnancy. Advise females of reproductive potential to use effective contraception during BRIUMVI treatment and for 6 months after the last dose. Reduction in Immunoglobulins: As expected with any B-cell depleting therapy, decreased immunoglobulin levels were observed. Decrease in immunoglobulin M (IgM) was reported in 0.6% of BRIUMVI-treated patients compared to none of the patients treated with teriflunomide in RMS clinical trials. Monitor the levels of quantitative serum immunoglobulins during treatment, especially in patients with opportunistic or recurrent infections, and after discontinuation of therapy, until B-cell repletion. Consider discontinuing BRIUMVI therapy if a patient with low immunoglobulins develops a serious opportunistic infection or recurrent infections, or if prolonged hypogammaglobulinemia requires treatment with intravenous immunoglobulins. Liver Injury: Clinically significant liver injury, without findings of viral hepatitis, has been reported in the postmarketing setting in patients treated with anti-CD20 B-cell depleting therapies approved for the treatment of MS, including BRIUMVI. Signs of liver injury, including markedly elevated serum hepatic enzymes with elevated total bilirubin, have occurred from weeks to months after administration. Patients treated with BRIUMVI found to have an alanine aminotransaminase (ALT) or aspartate aminotransferase (AST) greater than 3x the upper limit of normal (ULN) with serum total bilirubin greater than 2x ULN are potentially at risk for severe drug-induced liver injury. Obtain liver function tests prior to initiating treatment with BRIUMVI, and monitor for signs and symptoms of any hepatic injury during treatment. Measure serum aminotransferases, alkaline phosphatase, and bilirubin levels promptly in patients who report symptoms that may indicate liver injury, including new or worsening fatigue, anorexia, nausea, vomiting, right upper abdominal discomfort, dark urine, or jaundice. If liver injury is present and an alternative etiology is not identified, discontinue BRIUMVI. Most Common Adverse Reactions: The most common adverse reactions in RMS trials (incidence of at least 10%) were infusion reactions and upper respiratory tract infections. Physicians, pharmacists, or other healthcare professionals with questions about BRIUMVI should visit www.briumvi.com. ABOUT BRIUMVI PATIENT SUPPORT in the U.S. BRIUMVI Patient Support is a flexible program designed by TG Therapeutics to support U.S. patients through their treatment journey in a way that works best for them. More information about the BRIUMVI Patient Support program can be accessed at www.briumvipatientsupport.com. ABOUT MULTIPLE SCLEROSIS Relapsing multiple sclerosis (RMS) is a chronic demyelinating disease of the central nervous system (CNS) and includes people with relapsing-remitting multiple sclerosis (RRMS) and people with secondary progressive multiple sclerosis (SPMS) who continue to experience relapses. RRMS is the most common form of multiple sclerosis (MS) and is characterized by episodes of new or worsening signs or symptoms (relapses) followed by periods of recovery. It is estimated that nearly 1 million people are living with MS in the United States and approximately 85% are initially diagnosed with RRMS.1,2 The majority of people who are diagnosed with RRMS will eventually transition to SPMS, in which they experience steadily worsening disability over time. Worldwide, more than 2.3 million people have a diagnosis of MS.1 ABOUT TG THERAPEUTICS TG Therapeutics is a fully integrated, commercial stage, biopharmaceutical company focused on the acquisition, development and commercialization of novel treatments for B-cell diseases. In addition to a research pipeline including several investigational medicines, TG Therapeutics has received approval from the U.S. Food and Drug Administration (FDA) for BRIUMVI® (ublituximab-xiiy) for the treatment of adult patients with relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, as well as approval from several regulatory agencies outside of the U.S. for BRIUMVI to treat adult patients with RMS who have active disease defined by clinical or imaging features. For more information, visit www.tgtherapeutics.com, and follow us on X (formerly Twitter) @TGTherapeutics and on LinkedIn. BRIUMVI® is a registered trademark of TG Therapeutics, Inc. Cautionary Statement This press release contains forward-looking statements that involve a number of risks and uncertainties. All statements contained in this press release other than statements of historical facts, including statements regarding our future results of operations and financial position, our strategic and financial initiatives, our business strategy, and objectives for future operations may constitute forward-looking statements. For those statements, we claim the protection of the safe harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. Any forward-looking statements in this press release are based on management's current expectations and beliefs and are subject to a number of risks, uncertainties and important factors that may cause actual events or results to differ materially from those expressed or implied by any forward-looking statements contained in this press release. The preliminary, estimated financial results for the fourth quarter and fiscal year ended 2025 and the 2026 guidance estimates contained in this press release contain forward-looking statements and are subject to the completion of management’s and the audit committee’s final reviews and our other financial closing procedures and are therefore subject to change. The preliminary financial information and estimates included herein have not been examined or reviewed by our independent auditors and they are subject to revision as we prepare our financial statements as of and for the quarter and fiscal year ended December 31, 2025, including all disclosures required by U.S. generally accepted accounting principles. You should not place undue reliance on such preliminary information and estimates because they may prove to be materially inaccurate. While we believe that such preliminary information and estimates are based on reasonable assumptions, actual results may vary, and such variations may be material. Forward looking statements include but are not limited to statements regarding the estimated preliminary financial results referred to above, expectations for the timing and success of the commercialization and availability of BRIUMVI® (ublituximab-xiiy) for RMS in the United States, or any jurisdictions outside of the United States; anticipated healthcare professional (HCP) and patient acceptance and use of BRIUMVI for the approved indications; expectations of future revenue for BRIUMVI, or TG expenses or profit estimates or targets; our ability to execute the proposed share repurchase program; expectations and timing for our clinical trials of subcutaneous ublituximab (the active ingredient in BRIUMVI), and sometimes referred to as subcutaneous BRIUMVI, including feasibility, approvability and commercial acceptance; expectations and timing for our ENHANCE Phase 3 trial combining day 1 and day 15 doses, including, feasibility, approvability and commercial acceptance and impact on BRIUMVI sales; and expectations and timing for any of our pipeline products or programs, including Azer-cel or BRIUMVI in MG. Additional factors that could cause our actual results to differ materially include the following: the Company’s ability to continue to commercialize BRIUMVI; the risk that trends in prescriptions are not maintained or that prescriptions are not filled; the failure to obtain and maintain payor coverage; the risk that HCP interest in BRIUMVI will not be sustained; the risk that momentum in sales for BRIUMVI will not be sustained during the course of the year; the risk that the commercialization of BRIUMVI does not continue to exceed expectations; the risk that our BRIUMVI revenue targets will not be achieved; the failure to obtain and maintain requisite regulatory approvals, including the risk that the Company fails to satisfy post-approval regulatory requirements, the potential for variations from the Company’s projections and estimates about the potential market for BRIUMVI due to a number of factors, including, further limitations that regulators may impose on the required labeling for BRIUMVI (such as modifications, resulting from safety signals that arise in the post-marketing setting or in the long-term extension study from the ULTIMATE I and II clinical trials); the Company’s ability to meet post-approval compliance obligations (on topics including but not limited to product quality, product distribution and supply chain, pharmacovigilance, and sales and marketing); the Company’s reliance on third parties for manufacturing, distribution and supply, and other support functions for our clinical and commercial products, including BRIUMVI, and the ability of the Company and its manufacturers and suppliers to produce and deliver BRIUMVI to meet the market demand for BRIUMVI; the risk that any individual patient’s clinical experience in the post-marketing setting, or the aggregate patient experience in the post-marketing setting, may differ from that demonstrated in controlled clinical trials such as ULTIMATE I and II; the risk that the Company does not achieve its 2026 development pipeline anticipated milestones or goals in the timeframe projected or at all; the risk that the subcutaneous Phase 3 program will not be successful or if successful still will not be approved by the FDA or achieve commercial acceptance; the risk that the ENHANCE Phase 3 trial will not be successful or if successful will not be approved by the FDA or achieve commercial acceptance; the risk that we will not move forward with the development of BRIUMVI in MG and azer-cel following these preliminary studies; the uncertainties generally inherent in research and development; regulatory developments, legislative actions, executive orders, including the imposition of tariffs and policy changes in the U.S. and other jurisdictions; and general political, economic and business conditions. Further discussion about these and other risks and uncertainties can be found in our Annual Report on Form 10-K for the fiscal year ended December 31, 2024 and in our other filings with the Securities and Exchange Commission. Any forward-looking statements set forth in this press release speak only as of the date of this press release. We do not undertake to update any of these forward-looking statements to reflect events or circumstances that occur after the date hereof. This press release and prior releases are available at www.tgtherapeutics.com. The information found on our website is not incorporated by reference into this press release and is included for reference purposes only. CONTACT: 1. MS Prevalence. National Multiple Sclerosis Society website. https://www.nationalmssociety.org/About-the-Society/MS-Prevalence. Accessed October 26, 2020. 2. Multiple Sclerosis International Federation, 2013 via Data monitor p. 236.

编者按：多发性硬化（MS）是一种致残性自身免疫性中枢神经系统疾病。根据世界卫生组织官网数据，全球MS患者超过了180万。过去十多年间，多款疗法获监管机构批准治疗MS，极大改善了患者的生存状况。同时，全球目前还有一系列针对MS的研发管线正在持续推进，旨在为患者提供更好的治疗选择。作为全球医药创新的赋能者，药明康德一直以来依托“一体化、端到端”的CRDMO赋能平台，助力全球合作伙伴，推进包括MS在内各类疾病的创新疗法开发，加速造福病患。 多发性硬化（MS）是一种终身进展的中枢神经系统自身免疫病，迄今还没有治愈手段。该病多见于中青年群体，女性患病率更高。MS的核心病理是免疫系统错误攻击包裹神经纤维的髓鞘，使其不断受损、脱落，进而影响大脑、脊髓及视神经的正常传导功能。MS会导致患者的行动能力与认知功能逐渐下降。 根据病程特点，多发性硬化可分为四种类型：复发缓解型（RRMS）、继发进展型（SPMS）、原发进展型（PPMS）和进展复发型（PRMS）。其中RRMS最为常见，疾病常呈周期性复发与缓解，但每次缓解可能并不完全，残留症状会逐渐累积。RRMS患者有约四分之一在确诊10年内进展为SPMS，随着时间推移这一比例将更高。一旦进入SPMS阶段，症状多呈持续恶化趋势，患者逐渐丧失生活自理能力，甚至面临视力丧失和生命威胁。 图片来源：123RF 从19世纪到20世纪上半叶，科学界逐渐揭示MS的神经病学本质和其背后的免疫异常机制。20世纪50年代，科学家发现可的松等糖皮质激素能够缓解MS急性发作，但无法长期阻止疾病进展。 直到上世纪90年代，首批能够在缓解期控制病情的免疫调节剂问世，标志着“疾病修正疗法”时代的开启。随后，不同靶点、不同机制的疾病修正疗法相继出现，让控制MS进展成为了可能。过去十余年，更多新型疗法的不断诞生进一步改善了患者的长期预后。这篇文章也将回望近些年来多发性硬化创新疗法的发展历程。 传统免疫调节注射疗法 20世纪80年代末，研究者逐渐认识到异常的免疫攻击在多发性硬化病程恶化中发挥关键作用，于是开始探索各种免疫调节策略的治疗潜力。 重组人干扰素-β-1b（IFN-β-1b）首先成为突破口。临床研究显示，它能显著延缓复发缓解型多发性硬化（RRMS）的自然进展，使患者在两年内的复发次数减少约34%。1993年7月，IFN-β-1b（商品名Betaseron）获FDA批准，成为能够真正改变RRMS病程的治疗手段。2022年，同类药物干扰素-β-1a（商品名Rebif）获批，其既能降低复发频率，还可延缓持续性残疾的出现。2014年，Rebif的升级版本——聚乙二醇化干扰素-β-1a（peginterferon-β-1a，商品名Plegridy）获FDA批准，延长了体内作用时间，从而降低给药频率，提高患者的长期依从性。 图片来源：123RF 除干扰素外，格拉替雷（glatiramer，商品名Copaxone）也是早期注射型免疫调节剂之一。它由四种氨基酸构成的多肽混合物组成，能够竞争性阻断免疫细胞与髓磷脂的异常相互作用，从而发挥保护作用。该药于1996年获FDA批准，用于RRMS的长期治疗。 这些注射疗法的成功标志着MS治疗从单纯缓解症状迈向真正能够改变病程的疾病修正治疗阶段。这类传统免疫调节剂至今仍是MS治疗体系中的重要基石。 生物制剂靶向疗法问世 传统免疫调节注射疗法改变了MS的治疗格局，但仍有约三分之一的患者几乎无应答。为了让更多患者获益，科研界和产业界开始探索生物制剂靶向疗法。 由Athena Neuroscience、Elan与渤健合作开发的natalizumab，是首个获批用于MS治疗的生物制剂类靶向药物。它的出现，源于一次“误打误撞”的研究发现。 20世纪90年代，斯坦福大学斯坦曼实验室与Athena Neuroscience的泰德·耶德诺克（Ted Yednock）博士团队合作，希望了解MS的关键病理环节之一——淋巴细胞如何穿透血脑屏障。在动物实验中，他们意外发现一种“推波助澜”的分子——α4β1整合素，它能帮助淋巴细胞越过血脑屏障，引发大脑炎症。更令人惊喜的是，相应的抗体能够抑制这种异常浸润。 图片来源：123RF 意识到这项发现的突破性意义后，团队迅速调整方向，研发出针对这一靶点的人源化单抗natalizumab。凭借出色的临床数据，Tysabri（natalizumab，那他珠单抗）在2004年获FDA批准上市，用于RRMS的治疗。 长期随访数据进一步证实了其疗效：治疗两年后，与安慰剂相比，患者的残疾持续进展风险下降42%-54%，年复发率下降68%。 2014年，另一款靶向CD52的Lemtrada（alemtuzumab，阿仑单抗）也获批用于MS治疗。这一药物早在20世纪90年代末就已在少量患者中展现出抑制大脑新发炎症与减少复发的潜力。然而，尽管炎症减少，大多数患者仍表现出疾病进展，这一矛盾曾让研究团队困惑不已。 多年研究后，谜底终于揭晓：在MS的病程中，“炎症”与“退行性神经损伤”是相互关联但又相对独立的两条病理轨迹。MS的发作会引发炎症，同时累积神经损害；当损害达到一定程度后，即便炎症消退，退行性进展也会继续，就像滚下雪坡的雪球很难停止。因此，研究者推断：要让alemtuzumab发挥最大价值，需要尽可能在疾病早期使用。 后续的临床研究显示，接受alemtuzumab治疗三年后，患者年复发率下降74%，持续残疾累积风险下降71%，残疾评分也明显改善。最终，这款药物获得FDA批准，为RRMS患者带来了新的选择。 自2016年起，多款靶向CD20的单克隆抗体陆续获FDA批准，包括：Ocrevus（ocrelizumab，奥瑞利珠单抗）；Kesimpta（ofatumumab，奥法妥木单抗）；Briumvi（ublituximab，乌妥昔单抗）等。其中，奥瑞利珠单抗是FDA批准的首个用于PPMS的创新疗法。PPMS占MS患者的约10%，没有明显缓解期，残疾累积更快，生活质量常受严重影响。 长期随访数据显示，经过奥瑞利珠单抗治疗11年后，PPSM患者中有33%的患者无残疾进展、80%的人无需依赖轮椅（部分患者可能需要比轮椅更简单的助行器）。相比大多数MS生物制剂每月1次的用药频率，这款药物只需半年输注1次，提高了患者的依从性。 小分子疗法接力治疗 在相当长的时间内，获批上市的MS疗法往往需要注射治疗。因此，科学家们也在寻找用药更便捷的小分子口服药物，作用机制各异的小分子疗法由此诞生。 2010年1月，达伐吡啶（dalfampridine，商品名：Ampyra）正式获FDA批准，成为首个用于MS的口服药物。它是一种钾通道阻滞剂，通过改善脱髓鞘神经纤维的信号传导，帮助患者缓解步行能力下降这一最常见的功能障碍。临床研究显示，约三分之一的患者在服用达伐吡啶后步行速度明显提升，部分患者甚至能接近恢复正常步态。 另外，特立氟胺（teriflunomide，商品名：Aubagio）通过抑制二氢乳清酸脱氢酶来抑制活化T/B细胞的增殖，但保留正常免疫反应；富马酸二甲酯（dimethyl fumarate，商品名：Tecfidera）及其升级版本富马酸地洛西美（diroximel fumarate，商品名：Vumerity）则通过激活Nrf2通路发挥免疫调节及细胞保护作用。 其中，S1P受体调节剂因靶点明确、疗效突出而成为一类重要的小分子疗法。2010年9月，芬戈莫德（fingolimod，商品名：Gilenya）获FDA批准，成为可显著降低MS复发率的口服疗法。它通过与淋巴细胞表面的S1P受体结合，使其滞留在淋巴结，从而减轻中枢神经系统的炎症。长期临床试验表明，使用芬戈莫德治疗10年后，46%的患者无复发。 芬戈莫德的升级产品——第二代选择性S1P受体调节剂西尼莫德（siponimod）对S1P受体中的特定亚型S1P1、S1P5具有高度的选择性。它通过与二者的结合，既能阻止淋巴细胞进入中枢神经系统、降低炎症反应，还能穿透血脑屏障、促进髓鞘再生，起到神经修复作用。 更多新研究助力MS治疗 尽管现有疗法在治疗MS方面已显示出疗效，然而由于血脑屏障的存在，它们在清除中枢神经系统中的浆细胞方面效果有限。而科学家正考虑借助嵌合抗原受体T细胞（CAR-T）技术，来帮助解决这一难题。 今年，一项《细胞》研究证实了靶向B细胞成熟抗原的CAR-T疗法在治疗进展型多发性硬化（PMS）中的安全性和有效性。据介绍，共有5名PMS患者参与了1期临床试验，他们接受了抗BCMA CAR-T细胞疗法。结果，患者中枢神经系统中的浆细胞减少。在随访时间最长为9个月的病例队列中，观察到了显著的功能改善。此外，治疗还减轻了患者脑脊液中的小胶质细胞活化。 今年的另一项《细胞》研究指出，在MS患者的神经元中，干扰素-γ（IFNγ）会诱导免疫蛋白酶体亚基PSMB8的表达，导致代谢关键酶PFKFB3积累，进而引发炎症和神经退行性病变。而抑制这两种分子，能够在小鼠中改善MS症状，从而为MS治疗提供了新的靶点。 如今，产业界也在不断探索，致力于为患者带来更安全、有效、便利的治疗选择。过去25年间，FDA共批准了至少15款治疗MS的新疗法。当前，有近80款针对MS的新疗法正处于积极的临床研究中，其中数款疗法已进入3期临床阶段，涵盖布鲁顿酪氨酸激酶（BTK）抑制剂、CD40L靶向单抗、CD19靶向双抗等。 作为全球医药创新的赋能者，药明康德在过去25年发展历程中，很荣幸为其中一些获批疗法或在研疗法提供赋能，通过“一体化、端到端”的CRDMO赋能平台，助力全球合作伙伴加速创新疗法的研发进程、从而早日造福病患。 在对抗MS的漫漫征途中，科学家数十年如一日的追寻带来了一款又一款的MS疗法。我们也期待，在未来能见证更多创新疗法的问世，帮助更多患者开启生命的新篇章。 参考资料： [1] Atlas-3rd-Edition-Epidemiology-report-EN-updated-30-9-20.pdf.  Retrieved Oct 20, 2025 from https://www.msif.org/wp-content/uploads/2020/10/Atlas-3rd-Edition-Epidemiology-report-EN-updated-30-9-20.pdf [2] History of Multiple Sclerosis | MSAA. Retrieved Oct 20, 2025 from https://mymsaa.org/ms-information/overview/history/ [3] Ransohoff, R. M., Hafler, D. A., & Lucchinetti, C. F. (2015). Multiple sclerosis—a quiet revolution. Nature Reviews Neurology, 11(3), 134-142. doi: 10.1038 / nrneurol.2015.14 [4] Lublin, F. (2005). History of modern multiple sclerosis therapy. Journal of Neurology, 252(Suppl 3), iii3-iii9. https://doi.org/10.1007/s00415-005-2010-6 [5] Treatment of Multiple Sclerosis. Retrieved Oct 20, 2025 from  https://www.nature.com/collections/whyfzwfvvr/timeline/ 欢迎转发到朋友圈，谢绝转载到其他平台。如有开设白名单需求，请在“学术经纬”公众号主页回复“转载”获取转载须知。其他合作需求，请联系wuxi_media@wuxiapptec.com。 免责声明：本文仅作信息交流之目的，文中观点不代表药明康德立场，亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导，请前往正规医院就诊。 更多推荐 点个“在看”再走吧~