What the trial was testing
The ULTIMATE I AND II enrolled 545 patients with multiple sclerosis. The study was sponsored by TG Therapeutics, Inc. and tracked outcomes across the full group of patients who matched the trial's eligibility profile.
It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.
What the results showed
The infusion cut MS relapses by half compared to a daily pill over two years.
The New England journal of medicine · 2022 · NCT03277248
These findings — that compared to a daily pill over two years — were published in the The New England journal of medicine and represent the headline result of the study.
Researchers tracked outcomes across 545 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.
What this means for patients
For patients with multiple sclerosis, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.
What you can do now
This infusion is FDA-approved for relapsing MS and works differently than many pills — it targets the immune cells that attack your nervous system. About half of people get mild reactions during the infusion (like fever or chills), and serious infections happened in 1 in 20 people. Ask your doctor if this treatment fits your MS type and health history.
Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.
Open multiple sclerosis trials
Multiple Sclerosis Implementation Network (Registry)
The Multiple Sclerosis Implementation Network (MSIN) is a collaboration between the Multiple Sclerosis Association of America (MSAA), The University of Texas Health Science Center at Houston (UTHealth Houston), Dell Medical School at The University of Texas at Austin, and Novartis Pharmaceuticals Corporation. The goal of MSIN is to improve Multiple Sclerosis (MS) care, patient health, and quality of life through the development and support of implementation research and clinical practice collaboration. MSIN brings together healthcare teams, people with MS, and research leaders in MS and implementation science (IS) to learn, share, test, implement, and disseminate innovations that improve MS care, patient health, and quality of life. This ClinicalTrials.gov record pertains to the MSIN Patient Registry, which is a comprehensive database that integrates participants' electronic health records from various providers.
Safety and Efficacy of Fecal Microbiota Transplantation
The gut microbiota is critical to health and functions with a level of complexity comparable to that of an organ system. Dysbiosis, or alterations of this gut microbiota ecology, have been implicated in a number of disease states. Fecal microbiota transplantation (FMT), defined as infusion of feces from healthy donors to affected subjects, is a method to restore a balanced gut microbiota and has attracted great interest in recent years due to its efficacy and ease of use. FMT is now recommended as the most effective therapy for CDI not responding to standard therapies. Recent studies have suggested that dysbiosis is associated with a variety of disorders, and that FMT could be a useful treatment. Randomized controlled trial has been conducted in a number of disorders and shown positive results, including alcoholic hepatitis, Crohn's disease (CD), ulcerative colitis (UC), pouchitis, irritable bowel syndrome (IBS), hepatic encephalopathy and metabolic syndrome. Case series/reports and pilot studies has shown positive results in other disorders including Celiac disease, functional dyspepsia, constipation, metabolic syndrome such as diabetes mellitus, multidrug-resistant, hepatic encephalopathy, multiple sclerosis, pseudo-obstruction, carbapenem-resistant Enterobacteriaceae (CRE) or Vancomycin-resistant Enterococci (VRE) infection, radiation-induced toxicity, multiple organ dysfunction, dysbiotic bowel syndrome, MRSA enteritis, Pseudomembranous enteritis, idiopathic thrombocytopenic purpura (ITP), and atopy. Despite FMT appears to be relatively safe and efficacious in treating a wide range of disease, its safety and efficacy in a usual clinical setting is unknown. More data is required to confirm safety and efficacy of FMT. Therefore, the investigators aim to conduct a pilot study to investigate the efficacy and safety of FMT in a variety of dysbiosis-associated disorder.