Saturday, May 30

Health Watch: MS Computer Game

WAGA Fox 5 Atlanta GA. for video news report

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Medical marijuana bill clears Illinois Senate

SPRINGFIELD - With the help of key suburban votes, a plan to let those suffering from certain medical ailments and conditions use marijuana cleared the Illinois Senate Wednesday.

The plan was approved 30-28 in the 59-member chamber, garnering the bare minimum of votes needed.

"This is not recreational," said state Sen. Linda Holmes, an Aurora Democrat who has multiple sclerosis. She said the issue is helping people with debilitating conditions improve their quality of life.

"It is long overdue," said Holmes, one of five area Democrats to vote "yes."

The ailments or conditions spelled out in the proposed law for legal use of marijuana include cancer, glaucoma, HIV, hepatitis C, Crohn's disease, Alzheimer's, epileptic seizures and muscle spasms associated with multiple sclerosis. ...full story in the Daily Herald

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Increased Scrutiny of Opioids Could Alter Prescribing Practice

GAITHERSBURG, Md., May 28 -- If a formal risk reduction plan for opioid painkillers increases the regulatory burden on physicians, they may simply stop prescribing such drugs, to the detriment of patients in severe pain, the FDA was told Thursday.

The FDA's Center for Drug Evaluation and Research wrapped up a two-day public hearing here to get input from physicians, pain patients, pharmacists, hospice workers, addiction groups, and others to decide what factors it should consider in drafting a Risk Evaluation and Mitigation Strategy (REMS) aimed at reducing adverse events caused by opioids.

The REMS would be the largest to date and govern all extended-release opioid drugs, with the possibility of including regular-release opioids. ...full report in MedPage Today

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What's new for 'Multiple Sclerosis in Medical News Today

Link Between Vitamin D And Reduction In Multiple Sclerosis Risk - Could a holiday in the sun reduce the risk of developing multiple sclerosis? In a recent review for F1000 Medicine Reports, Bridget Bagert and Dennis Bourdette highlight recent advances in potential treatments. ...full report in Medical News Today

One Size Does Not Fit All: A New Look At Therapies - Statins, a commonly prescribed class of drugs used by millions worldwide to effectively lower blood cholesterol levels, may actually have a negative impact in Multiple Sclerosis (MS) patients treated with high daily dosages. ...full report in Medical News Today

Prescribing Sunshine For Multiple Sclerosis? - Could a holiday in the sun reduce the risk of developing multiple sclerosis? In a recent review for F1000 Medicine Reports, Bridget Bagert and Dennis Bourdette highlight recent advances in potential treatments. ....full report in Medical News Today

MS Patients Report Greater Treatment Satisfaction With TYSABRI - Biogen Idec (NASDAQ: BIIB) and Elan Corporation, plc (NYSE: ELN) have announced interim results from an ongoing, one-year longitudinal health-outcomes study in which patients reported significantly higher levels of treatment satisfaction after three infusions with TYSABRI® (natalizumab) when compared to multiple sclerosis (MS) therapies used previously. The findings from the study, which were reported by patients on therapy, further demonstrate the benefits of TYSABRI in treating MS and are helping to redefine successful treatment of the disease. The study, which was performed in conjunction with HealthCore Inc., a health-outcomes research company, is being presented in a poster today during the 23rd Annual Meeting of the Consortium of Multiple Sclerosis Centers. ....full report in Medical News Today

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What's new for 'Multiple Sclerosis' in PubMed

Factors perceived as being related to accidental falls by persons with multiple sclerosis. - This study explores and describes factors that persons with multiple sclerosis (MS) perceive as being related to accidental falls.....Investigating accidental falls using the perspective of the patient gave important information about variables not earlier targeted in MS research. - Disabil Rehabil. 2009 May 16:1-10. [Epub ahead of print] in PubMed

A longitudinal study of cognition in nursing home residents with multiple sclerosis. - Over the first 4 years of a nursing home stay, cognition deteriorates in individuals with MS. Though there are not different rates of decline, residents with MS-Neuro and MS-Comb perform worse than residents with MS or MS-Psyc. - Disabil Rehabil. 2009 May 19:1-8. [Epub ahead of print] in PubMed

Ambulatory rehabilitation in multiple sclerosis. - In this review, we summarise the primary factors affecting ambulation and highlight available treatment methods. We review studies that have attempted to characterise gait deficits within this patient population. Finally, as ambulatory rehabilitation requires multidisciplinary interventions, we examine approaches, which may serve to support and maintain ambulation within this patient group for as long as possible. - Disabil Rehabil. 2009 May 19:1-8. [Epub ahead of print] in Pubmed

Quality of life in MS: Does aging enhance perceptions of mental health? - Results suggest that perhaps the process of getting older, or factors related to being older, enhance perceptions of mental health in individuals with MS. Results are discussed within the context of social comparison theory, which might be an adaptive strategy that could underlie response shift in older individuals with MS. - Disabil Rehabil. 2009 May 18:1-8. [Epub ahead of print] in PubMed

The perceived benefits and barriers to exercise participation in persons with multiple sclerosis. - When compared with previous studies conducted in the general population, the participants in the present study reported different perceived barriers to exercise participation. Furthermore, awareness of the benefits of physical activity is not sufficient to promote exercise participation in persons with MS. Perceived exercise self-efficacy is shown to play an important role in promoting exercise participation in persons with MS. - Disabil Rehabil. 2009 May 21:1-7. [Epub ahead of print] in PubMed

A study analysing inconsistent responses from people with multiple sclerosis in a recent national audit. - This study has revealed that simple, single questions on satisfaction with services do not offer a valid measure of patient experience. It has shown that there is a place for qualitative research in the area of patient satisfaction. - Disabil Rehabil. 2009 May 21:1-9. [Epub ahead of print] in PubMed

Development, standardisation and pilot testing of an online fatigue self-management program. - Disabil Rehabil. 2009 May 19:1-11. [Epub ahead of print] in PubMed

Exploring physical activity behaviour of persons with multiple sclerosis: a qualitative pilot study. - Results from this pilot study suggest that PA interventions will need to implement multiple strategies that target self-efficacy, social environment and coping styles. We found SCT and TMSC useful in understanding PA behaviour among persons with MS; however, a limitation to these theories is that they are not explicit in the relationship between health and cognitions. Future research will need to explore how to incorporate models of health and function into existing behaviour change theories. - Disabil Rehabil. 2009 May 21:1-14. [Epub ahead of print] in PubMed

Increased plasma levels of brain derived neurotrophic factor (BDNF) after multiple sclerosis relapse. - Our results provide some evidence for the involvement of BDNF in the pathogenesis of MS and suggest a role for this neurotrophin during the recovery of acute demyelinating inflammatory lesion. - Neurosco Lett. 2009 May 25. [Epub ahead of print] in PubMed

[Multiple sclerosis and pregnancy] - Mulltiple sclerosis and pregnancy Multiple sclerosis (MS) is diagnosed between the second and fourth decade. More than 2/3 of patients are women and are often in childbearing age. We may ask two main questions: Which implication of pregnancy on the evolution of MS has to be considered ? Which influence of MS on the pregnancy is expected? In other words could the pregnancy worsen MS and could MS represent specific risks for the pregnancy? - Rev Med Suisse. 2009 Apr 29;5(201):936, 938-40. in PubMed

[Neurobehavioral changes occurring during multiple sclerosis] - Behavioral changes occurring in patients affected by multiple sclerosis (MSI are often neglected by physicians but are actually part of the clinical spectrum of the disease. In addition, they are known to be responsible for a decline in the quality of life of MS patients. Recently, there has been a growing interest to investigate changes in the emotional experience of MS patients and their decision making, showing that the ability to take advantageous decisions was altered in MS. This paper reviews existing data on this topic. - Rev Med Suisse. 2009 Apr 29;5(201):951-4. in PubMed

Endogenous remyelination is induced by transplant rejection in a viral model of multiple sclerosis. - These data suggest that remyelination was initiated by the local response to xenograft transplantation. These findings illustrate the complexities of OPC transplantation into areas of robust immune-mediated pathology. - J Neuroimmunol. 2009 May 22. [Epub ahead of print] in PubMed

Quality of life in 1000 patients with early relapsing-remitting multiple sclerosis. - Quality of life is considerably impaired in early stages of MS. Treatment initiation with IM IFNbeta attenuates MS disease activity and improves QoL. Inability to work early during the disease is a major challenge for the social security systems. -Eur J Neurol. 2009 Jun;16(6):713-20. in PubMed

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Wednesday, May 27

Multiple Sclerosis - What Are People With MS and Their Health Care Providers Really Thinking?

- New national survey reveals insights on treatment of disease, psychosocial burden, and delays in starting treatment

ROCKLAND, Mass. and NEW YORK, May 27 /PRNewswire/ -- The National Multiple Sclerosis (MS) Society, in collaboration with EMD Serono, today released findings from a nationwide GfK Roper survey, "MS Viewpoints: Understanding the Outlook on Emerging Therapies" in conjunction with the first-ever World MS Day. The MS Viewpoints survey compared the perspectives of neurologists, MS nurses and other healthcare professionals (HCPs)* and people living with MS on treatments, psychosocial burdens of the disease, and delays in starting treatment. Results from the survey uncovered that people newly diagnosed with MS often delay starting treatment, citing fear or anxiety about current treatment options as a key reason.

About the Survey
Independent research group, GfK Roper Public Affairs & Media, conducted the survey, interviewing 250 neurologists, 250 MS nurses and other HCPs, and 250 people living with relapsing MS. Interviews focused on understanding and comparing views of the current treatment landscape and the potential impact of emerging therapies, and also explored some of the psycho-social barriers that people living with MS face on a daily basis. ....read the full story and learn more about this survey at PR Newswire

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Diabetes Drug Shows Promise Against Multiple Sclerosis

Newswise — A drug currently FDA-approved for use in diabetes shows some protective effects in the brains of patients with relapsing remitting multiple sclerosis, researchers at the University of Illinois at Chicago College of Medicine report in a study currently available online in the Journal of Neuroimmunology.

Patients taking pioglitazone showed significantly less loss of gray matter over the course of the one-year trial than patients taking placebo. Of the 21 patients who finished the study, patients taking pioglitazone had no adverse reactions and, further, found taking pioglitazone, which is administered in an oral tablet, easy.

The researchers focused on pioglitazone because of its known anti-inflammatory effects, Feinstein said. They used primary cultures of brain cells to show that pioglitazone reduced the production of toxic chemicals called cytokines and reactive oxygen species. These molecules are believed to be important in the development of symptoms in MS.

Claudia C. Kaiser, who was a post-doctoral student at UIC, is first author on the paper. Other authors are Dinesh Shukla and Demetrios Shias of UIC; Glen Stebbins, Dusan Stefoski and George Katsamakis of Rush University Medical Center; and Douglas Jeffrey of Wake Forest University School of Medicine. Takeda Pharmaceuticals funded the study and provided the drug but had no other involvement in the study. ....full report in NewsWise

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Tuesday, May 26

What's new for 'Multiple Sclerosis' in PubMed

Adult stem cell transplantation in autoimmune disease. - Hematopoietic stem cell transplantation for severe autoimmune disease has been shown to be feasible, and definitive phase III randomized trials are now in progress. Durable remission after immune reconstitution and tissue remodeling suggests an effect beyond profound immunosuppression. Mesenchymal stem cells show promise as immunomodulatory agents in autoimmune disease with low acute toxicity and no requirement for ablation of the recipient immune system. - Curr Opin Hematol. 2009 May 21. [Epub ahead of print] in PubMed

Retinal nerve fiber thickness in inflammatory demyelinating diseases of childhood onset. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

Pulmonary arterial hypertension associated with interferon beta treatment for multiple sclerosis: a case report. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

MRI measures show significant cerebellar gray matter volume loss in multiple sclerosis and are associated with cerebellar dysfunction. - Clinically relevant GM atrophy occurs in the cerebellum of MS patients and is more prominent than WM atrophy. As such, it may provide complementary data to other regional atrophy and intrinsic tissue measures. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

Evaluating potential therapies for bladder dysfunction in a mouse model of multiple sclerosis with high-resolution ultrasonography. - This study demonstrates a novel outcome measure in experimental MS that allows; repeated, non-invasive, high resolution ultrasonic monitoring of bladder function. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

Clinical trials of multiple sclerosis therapies: improvements to demonstrate long-term patient benefit. - This article reviews the key data and provides recommendations for optimizing clinical studies in MS to demonstrate long-term patient benefit. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

Multiple sclerosis rehabilitation outcomes: analysis of a national casemix data set from Australia. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

Fatigued patients with multiple sclerosis have impaired central muscle activation. - We conclude that impaired central motor activation is involved in MS-fatigue. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

Pharmacotherapy of multiple sclerosis: the PROOF trial. - Ultimately, the question of long-term efficacy of high- versus low-frequency INFB therapies remains unanswered. - Expert Opin Pharmacother. 2009 Jun;10(8):1235-1237. in PubMed

Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis. - Our study showed that the treatment of swallowing problems with neuromuscular electrostimulation in patients with multiple sclerosis in this sample was successful in the reduction of pooling of saliva and in the reduction of aspiration. - Ann Otol Rhinol Laryngol. 2009 Apr;118(4):241-6. in PubMed

Randomized study of interferon beta-1a, low-dose azathioprine, and low-dose corticosteroids in multiple sclerosis. - ConclusionIn IFNbeta-naïve patients with early active RRMS, combination treatment did not show superiority over IFNbeta-1a monotherapy. - Mult Scler. 2009 May 22. [Epub ahead of print] in PubMed

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Prescribing sunshine for multiple sclerosis?

Could a holiday in the sun reduce the risk of developing multiple sclerosis? In a recent review for F1000 Medicine Reports, Bridget Bagert and Dennis Bourdette highlight recent advances in potential treatments.

Multiple sclerosis (MS) results from a failure of the body to recognize itself. The immune system attacks and destroys the sheath that protects nerve fibres, as if it were a foreign body or infection. Vitamin D, which is produced in the skin in response to natural sunlight, is an immune system regulator. This might explain why MS is less common in sunnier countries.

Giving MS sufferers vitamin D pills - or encouraging them to spend more time in the sun - might be a cheap and easy treatment. Bagert and Bourdette point out that oral vitamin D therapy is now in phase II clinical trials, to see how well it works and how much would be needed.

They say "The arrival of effective oral agents will give MS patients more therapeutic options and will be a major advance in the global effort to alter the natural history of this chronic disease".
Story in Eurek Alert

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Launch of Highly Anticipated Oral Agents and Increasing Use of Current and Emerging Injectable Drugs Will Drive the Multiple Sclerosis Drug Market to

Emerging Novel Oral Therapies Will Garner 29 Percent of the Total Market in 2018, According to a New Report from Decision Resources

WALTHAM, Mass., May 26 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the approval and launch of highly anticipated oral agents as well as the increasing use of current and emerging injectable drugs will drive the overall multiple sclerosis drug market to nearly $10 billion in 2018 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan.

The new Pharmacor report entitled Multiple Sclerosis finds that emerging novel oral therapies, most notably Merck Serono/EMD Serono's oral cladribine and Novartis/Mitsubishi Tanabe's FTY-720 (fingolimod), will garner 29 percent of the total multiple sclerosis market in 2018. Oral cladribine and FTY-720 will together capture more than $2 billion in major market sales in 2018, despite safety concerns associated with both drugs. The report also finds that three additional emerging agents - Biogen Idec's pegylated interferon-beta-1a, Genzyme/Bayer Schering/Bayer HealthCare's alemtuzumab (currently marketed as Campath/MabCampath) and BioMS Medical/Eli Lilly's dirucotide - will also contribute substantially to market growth by providing new therapeutic options to patients.

"Owing to the multitude of emerging therapies in late stage development, each of which offers particular attributes, and because combination treatment in multiple sclerosis is rare, the market will become increasingly fragmented as current and emerging therapies vie for niche patient populations," said Decision Resources Analyst Bethany Kiernan, Ph.D. "Nevertheless, the need for efficacious, safe and/or convenient therapies will permit all agents--including those that show robust efficacy but bear serious safety risks--to fulfill crucial needs among patients, depending on the individual course of their disease."

The report also finds that, despite the improvements offered by emerging drugs, neurologists indicate that substantial unmet need remains for neuroprotective agents and for therapies that halt or reverse disease progression. Additionally, because many of the advantages offered by current and emerging agents are offset by significant drawbacks, opportunity remains for the development of therapies that possess a better balance of efficacy, safety and convenience. ....full report in PR Newswire

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Japanese find success for MS with Vitamin A-like drug

A man-made drug that is like Vitamin A has shown progress in controlling MS and some of the disease's worst symptoms. The results of the tests are published in the June issue of the American Journal of Pathology.

A group of Japanese scientists tested the synthetic retinoid AM80 at the National Institute of Neuroscience in Tokyo. They found that it prevents early symptoms of the autoimmune disease by blocking the function of Th17 T-cells, a type of immune cell known to play a role in the onset of multiple sclerosis.

In the Science Daily this week, the research team of Dr. Takahashi Yamamura (right), Dr. Christian Klemann and Dr. Shinji Oki (far left) announced the finding that the synthetic retinoid AM80 is effective in treating early symptoms in a mouse model of Multiple Sclerosis.

Their findings "conclude that treatment with the synthetic retinoid AM80 is a considerable intervention strategy for the acute phase of Th17-mediated autoimmune diseases such as MS."...full story in Examiner.com

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Struck down by the curse of MS - at age FIVE: Little Lucy reveals childhood toll of incurable disease

Lucy Wood is much like any other little girl. She adores Disney princesses and looking at her pony story books. Everyone knows her for her love of cuddles, and she dreams of being a pop star when she grows up.

But last summer, just a few days after her fifth birthday, she became one of the youngest people in Britain to be diagnosed with Multiple Sclerosis, the progressively disabling neurological condition.

For an adult such a diagnosis would be a dreadful blow, for a child it is unbearably cruel. 'Hearing the diagnosis was like being in a head-on car crash,' says her mother Sharon, 39. 'We already had a pretty good idea of what was wrong with Lucy but having it confirmed was horrific.' ...full story in the Daily Mail On Line

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Monday, May 25

One size does not fit all: A new look at therapies

Statins, a commonly prescribed class of drugs used by millions worldwide to effectively lower blood cholesterol levels, may actually have a negative impact in Multiple Sclerosis (MS) patients treated with high daily dosages.

A new study by researchers at the Montreal Neurological Institute (MNI), McGill University, demonstrates that statin therapy in mice inhibits myelin repair or remyelination in the central nervous system. The findings, published in The American Journal of Pathology, highlight the crucial need to monitor the effects of central nervous system-accessible immune therapies on the myelin repair processes in patients with MS and other progressive demyelinating diseases. ...read the full report in McGill University Health Centre

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Vitamin D may offer hope to sufferers of MS

New Canadian research is shedding light on intriguing evidence that vitamin D may cut relapse for some multiple sclerosis patients.

According to research presented at the annual meeting of the American Academy of Neurology, high doses of the vitamin appear safe for patients with MS and may even lead to a reduction in disease relapses.

Dr. Jodie Burton, a neurologist at the University of Toronto, studied 25 people with relapsing-remitting multiple sclerosis, a form of the illness characterized by relapses during which new symptoms can appear or old ones resurface.

"I think the results showing that vitamin D reduces attacks... require confirmation in a properly designed study," he said.

The best results in the study were only observed in those who took the larger doses. People in the high-dose group were given escalating doses of the vitamin for six months, to a maximum of 40,000 IU daily. Doses were then gradually lowered over the next six months, averaging out to 14,000 IU daily for the year.

Burton advises MS patients to talk to their doctors before beginning vitamin D supplements, noting that too much of the vitamin can be harmful for people with certain medical conditions such as kidney disease.

O'Connor advises other MS patients not to take too much vitamin D, suggesting they not exceed 2,000 IU to 4,000 IU units a day until further research can prove that higher doses aren't dangerous.

Recent research has found that proteins activated by vitamin D attach to a certain type of DNA, called DRB1-1501, which is believed to cause the disease.

Burton's team speculates that vitamin D reduces inflammation and stops the immune system from attacking its own cells, thereby ensuring the gene functions properly in the body. ...full report in CTV.ca

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Friends rally to help woman dealing with MS

Diann Carmichael’s family faces rising expenses as the Markdale-area woman’s multiple sclerosis reduces her independence.

A group of friends is organizing a fundraiser to help out.

“Having to accept help from the public isn’t easy for proud people who value independence and privacy. Diann suffers from a progressive form of multiple sclerosis which has put her into a wheelchair in just seven years and having to rely on others for help in a lot of everyday activities,” said Diann’s husband Darin Carmichael.

“Personally I’m not a really big fan of asking other people for money, but when you’re in a situation like this you have no choice. There’s a lot of expenses that come about here that we can’t handle on our own. All of our friends and family have been really good to chip in and organize this thing.

“A lot of things we wouldn’t be able to do without this as far as the van and the lift. We have to put a new wheelchair ramp on the house shortly. It’s got to be done,” he added.

“There are huge adjustments to accept . . . It’s really hard to admit that there are things I can’t do. My sister-in-law always says you just need to call and ask, but it takes a lot to make the call and ask that I need someone to help. If you’re an independent person you want to hold on to that as long as possible.”

The Sun Times

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Saturday, May 23

Video - Health Watch: Yearly MS Medicine

About 400,000 Americans are living with Multiple Sclerosis. MS is a disease of the central nervous system that is chronic and unpredictable. One Florida man said he was determined not to let MS dictate his life.
See Video news report WAGA Fox 5 Atlanta GA

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When Managed By Specialty Pharmacy, MS Patients More Compliant With Medications

Multiple sclerosis patients managed by a specialty pharmacy program were more compliant with medication, and had a lower risk of being hospitalized for their disease than those who were not managed by a specialty pharmacy program, according to a study completed by HealthCore, Inc.

HealthCore researcher Jingbo Yu presented the study at the International Society of Pharmacoeconomic and Outcomes Research 14th Annual International Meeting in Orlando, Fla. The retrospective study analyzed medical and pharmacy claims data.

The HealthCore study compared 3,055 patients managed by PrecisionRx Specialty Solutions to 807 patients who were not part of a specialty pharmacy-managed group over a period of one year. PrecisionRx provided patient education materials, regularly scheduled nurse calls and refill reminders to its members.

The study showed that those in the managed group had a 47 percent lower risk of being hospitalized to treat conditions associated with MS compared to the non-managed group. ...full study report in Medical News Today

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MS Societies In UK And Australia Provide International Research Opportunity

Worldwide collaborative ties among researchers investigating the debilitating neurological condition multiple sclerosis (MS) have been strengthened thanks to the introduction of the first UK and Australian Fellowship Exchange programme.

Dr Julia Morahan is the first person to be awarded the Macquarie Group Foundation Australia and UK MS Society Fellowship and she makes the move from investigating Motor Neurone Disease to research into MS.

The initiative cements the relationship between the UK MS Society and international scientists researching MS and is supported by the Macquarie Group Foundation - the philanthropic arm of Macquarie Group. ...full report in Medical News Today

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What Is Yeast Infection Or Candidiasis? What Is Vaginal Thrush?

Vaginal thrush (thrush) is a yeast infection caused by a type of fungus of the candida species, usually Candida albicans. It can affect all women, but is more common among women who are pregnant, those who have weakened immune systems, and women aged 30 to 50. Thrush is generally recurring - it comes back. The fungus, candida albicans, exists naturally in the vagina. As long as it does not multiply too much a woman will not notice it is there. However, if can sometimes multiply to such an extent that it causes swelling of the vagina and vulva. ...full report in Medical News Today

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Nicotinic Acid-Mediated Activation of Both Membrane and Nuclear Receptors towards Therapeutic Glucocorticoid Mimetics for Treating Multiple Sclerosis.

Nicotinic acid penetrates the blood brain barrier, cures pellagric dementia, has been used for over 50 years clinically without toxicity, and raises HDL concentrations to a greater degree than any pharmaceutical, thus providing unparalleled benefits against lipodystrophy. Summary analysis reveals that the expected therapeutic benefits of high-dose nicotinic acid administration far outweigh any known adverse risks in consideration for the treatment of multiple sclerosis.
PPAR Res. 2009;2009:853707. Epub 2009 May 17. in PubMed

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Patients with multiple sclerosis to form human chain on May 27

MUMBAI: Diagnosed with a debilitating neurological disorder at the prime of his career, ad firm executive Nadeem Naqvi admits he was near-suicidal a decade ago. On Friday, however, Naqvi offered the message of hope as he joined fellow patients, actor-cum-model Milind Soman and eminent neurologists in spreading the word on a little-known condition called multiple sclerosis (MS).

The Multiple Sclerosis Society of India (MSSI), a support group, will organise a human chain at Masina Hospital on May 27 to spread the message of hope to those suffering. MS is a chronic progressive incurable disease of the central nervous system. Naqvi said he was an active professional till he developed numbness on the left side of his body and was confined to bed for six months. "It was with the support of my family and friends that I was back on my feet,'' he said. Dadar resident Cawsi Randevia (54), too, said he would participate in the chain to encourage other patients that they could lead normal lives. .....full story in The Times of India

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Synthetic Vitamin A-Like Molecule Blocks Early MS

Tests in mice show AM80 prevents early symptoms but not chronic ones, study finds

FRIDAY, May 22 (HealthDay News) -- A synthetic vitamin A molecule has shown promise as an early treatment for multiple sclerosis.

In tests in mice, Christian Klemann and colleagues at the National Institute of Neuroscience in Tokyo found that the man-made retinoid AM80 prevents early symptoms of the autoimmune disease by blocking the function of Th17 T-cells, a type of immune cell known to play a role in the onset of multiple sclerosis. However, AM80 did not prevent chronic symptoms of the disease, according to the findings published in the June issue of the American Journal of Pathology.

The treatment -- which unlike some popular MS treatments didn't suppress the immune system and thus subject the patient to infection and other disease -- could be a "considerable intervention strategy for the acute phase of Th17-mediated autoimmune diseases such as MS," the researchers concluded.

More information: The National Multiple Sclerosis Society has more about MS.
Story in Forbes.com

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Friday, May 22

Health Watch: Yearly MS

ATLANTA (MyFOX ATLANTA) - About 400,000 Americans are living with Multiple Sclerosis. MS is a disease of the central nervous system that is chronic and unpredictable. One Florida man said he was determined not to let MS dictate his life.

MS is an autoimmune disease which for some reason causes body's own immune system to attack and destroy healthy tissue. In the case of MS, the disease destroys the protective coating around nerve fibers in the central nervous system.

Bradley Romp has had all kinds of symptoms, but he said he was determined not let the disease slow him down anytime soon.

Romp said he feels stronger now than when he was diagnosed with MS four years ago. Romp said his medication, combined with 50 miles or riding and hitting the gym three times a week have all helped him tackle MS.

Story and video on My Fox Atlanta

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Infusion specialist likes getting to know patients

On any given day, registered nurse Bev George may treat patients needing a simple blood transfusion, or deliver ongoing treatments to patients with multiple sclerosis, Crohn's disease or rheumatoid arthritis.

It's all in a day's work for George, who works in the infusion center, located in the Physician's Treatment Center or outpatient area of Central DuPage Hospital in Winfield.

She is in her 33rd year of nursing, having earned her registered nursing degree through a hospital-based program in Springfield, before she returned to the University of St. Francis in Joliet for her bachelor's degree.

Earlier this month, George took her education one step further: she earned a master's degree in nursing administrative studies at the University of Illinois at Chicago, which she hopes to use one day as a nurse educator.

But she still loves going to work each day, where she is among four registered nurses on shift, working with patient care technicians to handle a patient load of anywhere from 35 to 50 per day.

Most commonly she sees people coming in for a series of infusions of antibiotics for wound or blood infections, that might last every day for several weeks.

Additionally, she regularly administers regular IV infusions to patients with multiple sclerosis, Crohn's disease and rheumatoid arthritis, where their treatment schedule brings them in once a month, or once a week.

George began her career in critical care, taking care of premature infants in the Neonatal Intensive Care Unit, before branching out to work in pediatric home care, and helping parents to care for their preemies once they went home.

From there, she transitioned to adult home care, where much of their care included infusions. For nearly 10 years now, she has been back working in the hospital.

"You develop just a nice relationship with people," George says, "and you get to educate them about their care, and what to expect with home care." ..full story in Daily Herald

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AM80 Blocks Early Multiple Sclerosis in Mice

ScienceDaily (May 22, 2009) — Researchers led by Drs. Takahashi Yamamura and Shinji Oki at the National Institute of Neuroscience, Tokyo, Japan have found that the synthetic retinoid AM80 is effective in treating early symptoms in a mouse model of multiple sclerosis (MS). ....full report in Science Daily

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What's new for 'Multiple Sclerosis' in PubMed

Sweating impairment in patients with multiple sclerosis. - Acta Neurol Scand. 2009 May 19. [Epub ahead of print] in PubMed

Prognostic implications of a carefully performed neurological assessment in patients with a first event suggestive of multiple sclerosis. - These data indicate that a carefully performed neurological assessment of symptoms and signs is important for defining the risk of conversion to CDMS. - BMC Neurol. 2009 May 20;9(1):19. [Epub ahead of print] in PubMed

The significance of oligoclonal bands in multiple sclerosis: Relevance of demographic and clinical features, and immunogenetic backgrounds. -J Neurolimmunol. 2009 May 18. [Epub ahead of print] in PubMed

Cannabinoid-induced apoptosis in immune cells as a pathway to immunosuppression. - In this review, we will focus on apoptotic mechanisms of immunosuppression mediated by cannabinoids on different immune cell populations and discuss how activation of CB2 provides a novel therapeutic modality against inflammatory and autoimmune diseases as well as malignancies of the immune system, without exerting the untoward psychotropic effects. - Immunobiology. 2009 May 18. [Epub ahead of print] in PubMed

Humoral immune response to EBV in multiple sclerosis is associated with disease activity on MRI. - The correlation between elevated Epstein-Barr virus nuclear antigen 1 (EBNA-1) immunoglobulin G (IgG) and gadolinium-enhancing lesions suggests an association between Epstein-Barr virus (EBV) infection and multiple sclerosis (MS) disease activity. The heightened immune response to EBV in MS is specifically related to EBNA-1 IgG, a marker of the latent phase of the virus. The lack of association between acute viral reactivation in the peripheral blood and Gd(+) lesions suggests a limited role of the former in driving disease activity. - Neurology. 2009 May 20. [Epub ahead of print] in PubMed

Neutralizing Antibodies to Interferon-beta and other Immunological Treatments for Multiple Sclerosis: Prevalence and Impact on Outcomes. - The negative effect of NAbs on various outcome measures is very consistent across many studies, specifically when observation periods are longer than 2 years. NAbs against natalizumab occur less frequently (6%) and, like NAbs against IFNbeta, they are associated with a loss of clinical and radiological efficacy of the drug. -CNS Drugs. 2009;23(5):379-96. doi: 10.2165/00023210-200923050-00003. in PubMed

Ultrastructural Changes of Penile Cavernous Tissue in Multiple Sclerotic Rats. - The function of penile erection is affected by MS, and the ultrastructural pathological changes of the penile cavernous tissue may be one of the important mechanisms of ED caused by severity MS. Jiang J, He Y, and Jiang R. Ultrastructural changes of penile cavernous tissue in multiple sclerotic rats. - J Sex Med. 2009 May 7. [Epub ahead of print] in PubMed

Comparison of Diffusion Tensor-Based Tractography and Quantified Brain Atrophy for Analyzing Demyelination and Axonal Loss in MS. - J Neuroimaging. 2009 May 5. [Epub ahead of print] in PubMed

Immune cell membrane fatty acids and inflammatory marker, C-reactive protein, in patients with multiple sclerosis. - The present results suggest that the disease state may in part explain the reported inconsistencies in fatty acid levels in multiple sclerosis patients. - Br J Nutr. 2009 May 19:1-7. [Epub ahead of print] in PubMed

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Thursday, May 21

UPDATE 3-GW Pharma files cannabis drug for MS in Europe

LONDON, May 20 (Reuters) - A pioneering cannabis-based medicine for multiple sclerosis from GW Pharmaceuticals (GWP.L) has been filed for approval in Europe, paving the way for its potential approval at the end of 2009 or early in 2010.

Following numerous delays, the submission to regulators in Britain and Spain is a landmark for the British drugmaker, which also announced on Wednesday it had made a maiden net profit of 4.0 million pounds ($6.2 million) in the six months to March 31 from a 4.2 million loss a year ago.
Shares in the company rose 7.6 percent to 85 pence by midday after touching a high of 89.5p.

Clinical trials have shown GW's drug Sativex, which is sprayed under the tongue, reduces spasticity in multiple sclerosis patients who do not respond adequately to existing therapies.
If it is approved, Sativex will be marketed in Britain by Germany's Bayer (BAYG.DE) and in the rest of Europe by Spain's Almirall (ALM.MC).

Sativex became the world's first cannabis medicine to win regulatory approval when it was approved in Canada in 2005.

The drug -- extracted from marijuana plants grown at secret locations in the English countryside -- has been hit by a string of delays in Europe, where GW originally hoped to win approval in 2003.........continued in Reuters

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Chemical in Marijuana to Slow Multiple Sclerosis?

The NIH has granted Temple University researchers $1.5 million to test a laboratory-made version of cannabinoids for slowing the progress of multiple sclerosis. Cannabinoids are found in nature in the marijuana plant. Researchers believe that this class of chemicals can create immune suppression, which just might help in multiple sclerosis. Much like steroids (but with fewer side effects and much more selectively), cannabinoids can "switch off" a portion of the immune response and bring down inflammation and "hyperactivity" of immune cells, possibly preventing (or slowing) some of the damage caused to the myelin by immune cells. It does this by interacting with the receptors on specific immune cells.

Temple researchers have synthesized a compound that has this calming effect on the immune system without any of the psychoactive effects that are associated with marijuana. This four-year research project begins this summer. If successful, this could be a lovely addition to potential MS treatments (though I say this with caution, as preliminary research is just now being done)............About.com: Multiple Sclerosis

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Ransom Notes: Calling attention to MS

The doctors in St. Louis were pretty confident. They didn’t know what was ailing my wife, but one of them said, “Well, at least we know it isn’t multiple sclerosis.”

We were taken aback because at the time, we didn’t know anything about multiple sclerosis, but we thought anytime a doctor rules out a disease, it’s a good thing, right? Turns out the doctor was wrong. In 1988, another doctor (this one in Chicago) was even more sure that it was multiple sclerosis. It was the beginning of an odyssey that has had many ups, and many downs, but it set me on a course to find out as much about this disease as possible.

Turns out, the doctors in St. Louis were merely playing the odds. Multiple sclerosis, a neurological disease that causes the body’s immune system to actually attack its nerve cells, is considered much more prevalent among non-Blacks. The doctors figured that a Black woman was less likely to have the disease, so they ruled it out. But in the 22 years since that diagnosis, I have met dozens of Black people with the disease. It may be rare (it is estimated that 400,000 Americans have multiple sclerosis), but almost everyday I meet a new person who knows someone, who is married to someone, or who has a family member with the disease, and all of them are Black.

Oh yeah, one of them is Michelle Obama, whose father, Fraser, lived with the disease for more than 20 years. Good thing the doctors didn’t just rule it out for him (it is also supposed to be more prevalent among females). .............Chicago Defender

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Videographer and artist team up for documentary short

When Cheryl Bowlan met Elizabeth Jameson a decade ago, Bowlan remembers it was the beginning of a union of like minds poised for a higher calling — to serve as public interest artists — using art to create awareness of worthwhile causes.

So Jameson, a Lafayette resident, turned to painting after multiple sclerosis prevented her from continuing her law career. Bowlan, also of Lafayette, shifted from a communications and marketing field to becoming a public interest videographer and multimedia producer.
The idea to produce a documentary about Jameson came naturally.

"Over the years I've watched this vibrant, determined woman meet every new challenge with grace," said Bowlan. "The medical news is never good. She has a progressive form of MS. Shut out of the legal career she loved, Elizabeth turned to art. Here was a woman who had virtually no art training when she started. Nonetheless, she grabbed this lifeline and charged forward."

With Bowlan's own art background, she said she knows how one's ego can take a thrashing, especially as a beginner around young adults born with a pencil in hand or contemporaries who've already logged decades of experience.

"But Elizabeth plunged on. And, being Elizabeth, with her passion for social justice — one she ably expressed in her law career — she found a way to put her art to work for others," Bowlan said. Elizabeth wants her prints and paintings to educate and humanize MS for the medical community, she added........full story in MercuryNews.com

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New Source of Information on Multiple Sclerosis Medications

NeedyMeds.org and the National Multiple Sclerosis Society announce a new source of information on multiple sclerosis medications and the financial help available for those living with the disease.

(Vocus/PRWEB ) May 21, 2009 -- NeedyMeds, a national nonprofit, added a new resource page to its Web site tailored for those with multiple sclerosis. The page is a multiple sclerosis-specific source of help for those looking for information on the disease and financial resources to help assist with the cost of medications.

Find help with the cost of medicine

The resource page, created in collaboration with the National Multiple Sclerosis Society, provides information on this disease including an overview, frequently asked questions, research, and more. In addition, the page lists financial resources that help with the cost of the drugs used to treat multiple sclerosis, free clinics, and programs that provide other types of financial assistance.

This comprehensive information source is found at www.needymeds.org/resourcepages/ms.shtml or on the NeedyMeds homepage at needymeds.org.

NeedyMeds has the most comprehensive and reliable database of patient assistance programs available. All the information is free, easy to access, and updated regularly. There is no registration process or need for users to enter any personal information.

The National Multiple Sclerosis Society offers an information and referral line, support groups, patient education and research. Links to the National Multiple Sclerosis Society and its chapters, programs and services are also found on the resource page.

This collaboration of NeedyMeds and the National MS Society was created to reach a larger group of people needing support and assistance in a time of shrinking resources. Both organizations are committed to serving those in need.

PRWeb Press Release Newswire

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TWO WOMAN CLIMBERS WITH MULTIPLE SCLEROSIS NEAR SUMMIT OF MT EVEREST IN LEAD UP TO FIRST WORLD MS DAY

LEAD UP TO FIRST EVER WORLD MS DAY ON WEDNESDAY 27 MAY 2009

London Wednesday 20 May, 2009

American climbers Wendy Booker and Lori Schneider who both have Multiple Sclerosis are due to make their final assault on Mt Everest in the next 48 hours in the lead up to the first ever World MS Day.

Climbing in separate teams, they are believed to be the first people diagnosed with Multiple Sclerosis to attempt to reach the top of Mt. Everest. If she succeeds, Lori Schneider intends unveiling a flag with the logo of World MS Day at the summit (www.worldmsday.org)

This first ever World MS Day (Wednesday 27 May 2009) aims to be a day of unity, strength and solidarity, where people affected by MS across the world are urged to come together to take positive action on MS. The goal is to mobilise and expand the global MS movement by encouraging people to talk about their MS experiences, donate to support people affected by MS and to fund research, join MS organisations and encourage politicians to take action. It has been organised by the London-based Multiple Sclerosis International Federation (www.msif.org) and by MS Societies in 54 countries around the world.

Lori Schneider has carried a World MS Day banner in her backpack every step of the way and will take it with her to the summit of Everest. “I am climbing this mountain for all of us with MS, and all those who need to be reminded to live their dreams,” she says.

“Climbing a mountain is similar to having MS - you concentrate on taking one step at a time and congratulate yourself with each step. At first I saw my MS diagnosis as devastating. Now I see that it has been a positive catalyst in my life which has moved me closer to living my dreams. My mission is to give hope to others who are living with this condition."

"I use mountains as metaphors for the obstacles we all encounter in life," says Wendy Booker. “I want to inspire others - especially young people - not to see obstacles as mountains in their way, but more as challenges to 'climb' over and around. We all have such 'mountains' in our lives and we cannot let them stop us!", says Wendy Booker.

For updates on Wendy Booker’s Everest ascent: http://wendybooker.wordpress.com For updates on Lori Schneider’s Everest ascent: http://www.alpineascents.com/everest-cybercast.asp ..............PharmiWeb Solutions

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Tuesday, May 19

What's new for 'Multiple Sclerosis' in PubMed

Parity and secondary progression in multiple sclerosis. - We found no evidence that parity influences the risk of secondary progression in MS. Further population-based studies on the association of pregnancy and childbirth on the long-term prognosis of MS are needed. - J Neurol Meurosurg Psychiatry. 2009 Jun;80(6):676-8. in PubMed

Neurobiology and systems physiology of the endocannabinoid system. - The role of the endocannabinoid system in the development of drug dependence has been discussed controversially, but recent evidence suggests that chronic stimulation of the endocannabinoid system may facilitate drug dependence. - Pharmacopsychiatry. 2009 May;42 Suppl 1:S79-86. Epub 2009 May 11. in PubMed

Current approaches to the identification and management of breakthrough disease in patients with multiple sclerosis. - In this Review, we discuss proposed strategies to monitor patients with RRMS being treated with DMDs, outline approaches to identifying therapeutic response in individual patients, review MRI and biological markers of treatment response, and summarise the role of antibodies in biological therapies. We also outline possible strategies for the management of patients with breakthrough disease and highlight areas in which research is needed. - Lancet Neurol. 2009 Jun;8(6):545-59. in PubMed

Predicting and preventing the future: actively managing multiple sclerosis. - Pract Neurol. 2009 Jun;9(3):133-43. in PubMed

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Should marijuana be legally prescribed as a pain reliever in New York?

It's 3 p.m. on a Monday, and Joe Gamble is struggling to make a cup of tea.

His arm flails away from the counter several times before he's able to direct the sugar dispenser over the cup. The spoon twitches in his hand, banging against the sides of the mug.

Gamble pauses mid-sentence, unable to remember the ending of the story he just began telling.

Three hours have passed since Gamble, 33, last medicated himself. The symptoms of his multiple sclerosis are taking hold of his body.

Gamble takes a sip of tea and politely excuses himself. He shuffles to the door, climbs down two steps and plops down on the hood of the cherry red Porsche sitting in the driveway of his Liverpool home. He pulls a small marijuana pipe out of his pocket, brings it to his lips and inhales deeply.

A look of relief flashes across Gamble's face. He also looks a little guilty.

"Every time I light that pipe, I feel like a criminal," Gamble says. "I shouldn't have to. I'm way too sick for that."

A few puffs later and the change in Gamble is striking. The tension in his limbs lessens. His gait improves. He speaks clearly and freely.

"What am I supposed to do?" Gamble asks, almost pleading for approval. "Marijuana makes my life a little livable. I don't get stoned. I don't get that euphoric feeling. It just helps the tremors."

Two years ago, Gamble was diagnosed with primary progressive multiple sclerosis. Unlike other forms of the disease, Gamble's type of MS promises a steady progression of disability without relapse or remission. There is no cure.............full story in Syracuse.com

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Help for Improved Walking in Bend, Oregon: Physical Therapy Practice Now Offers State-of-the-Art Gait Training

Parkinson's disease, Multiple Sclerosis, Stroke and other movement disorder patients are now offered a new, breakthrough treatment for improving walking balance.
Bend, OR (PRWEB) May 18, 2009 -- Jennifer Brassfield, PT, DPT is a physical therapist on a mission: to help her patients with movement disorders--such as Parkinson's Disease and Multiple Sclerosis--walk as normally as possible for as long as possible. That's why her physical therapy services now include Augmented-Reality Gait Training with the GaitAid Virtual Walker from MediGait LTD.

The GaitAid Virtual Walker combines virtual-reality programming and real-time motion detection in a simple-to-use, cell-phone-sized device.

Will Be Provided for Home Use While Physical Therapy Continues

Worn for practice-walking just 20-30 minutes a day, GaitAid's visual and audio stimulation, keyed to the user's own body movement, sets up a normal walking pattern--sometimes from the first step. Over time, the device also "rewires" the wearer's brain to follow a healthier walking pattern--an effect that often continues even when it isn't being worn.

Lightweight and portable, GaitAid is designed to be used anywhere. Brassfield will provide the device for home use for the duration of a client's walking-therapy program.

For Many Patients, Improved Walking Means Renewed Independence

Besides restoring the ability to walk normally again, the GaitAid Virtual Walker allows those who benefit from it to step back into a more enjoyable, more independent life. As Brassfield says: "I am extremely excited to be able to offer this treatment modality to my patients. I've spent hours upon hours researching treatment techniques to improve the gait pattern of movement disorder patients, and after looking at the research, I'm convinced I'm going to see some very good outcomes from this technology. And that is very, very exciting.

Daniel Neal, from Palm Springs, CA, had this to say just after receiving his GaitAid to use at home: "As soon as I tried it my mobility improved tremendously! For the first time in over a year I am already walking without a cane. I am so impressed and so greatful. I was dreading my planned trip out of the country until I received your glasses. I cannot wait to share the miracle with my friends who suffer from PD. Thank you!" ....full story eMediaWire

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Bridal store turns away woman with MS

Every week, 200 people are diagnosed with multiple sclerosis, a disease that can make walking almost impossible for some patients.

For a North Texas woman, it turned her shopping trip for a wedding gown, into a confrontation.
The grandmother says she was kicked out of a store because of her service dog.

Neyo is a constant companion in Gloria Troutman's life.

The 62-year-old grandmother relies on the service animal to get around, since she lost control of half her body from multiple sclerosis.

"He's always right beside me, never leaves my side," said Troutman.

But on a recent trip to Town East Mall, a store kicked her out, she says, because of her service animal.

Every trip out is a challenge for Troutman.

But she was shopping with her granddaughter for wedding dresses, at Isis Bridal, inside the mall.
"They were like, 'we don't want the dog touching the dresses.' We were like 'he's not hurting anything,'" said Nicole Herring, Troutman's granddaughter.

The owner refused to talk to News 8.

"I was surprised and I felt bad at how they were treating my grandmother. It was like they were discriminating against us because she's in a wheelchair and has a dog," said Herring.

Indeed, the use of service animals in public is protected under law. Violators can face fines.
But Troutman would settle for an apology and a little sympathy in the future.
Isis Bridal & Formal Letter of Apology: ..........full story & apology in Txcnn.com (Texas Cable News)

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Saturday, May 16

40 days, 3500 miles, More Than $450,000 Raised – One Man’s Journey Toward a World Free of MS.

Phil Keoghan’s ride across America presented by GNC LiveWell may have ended in New York City on May 8, but his impact will live on.

In just 40 days, Keoghan logged well over 3,500 miles, climbed tens of thousands of feet, and in collaboration with GNC’s in-store fundraising campaign, raised over $450,000 for the National MS Society.

“Phil’s efforts galvanized the entire MS community. His incredible focus and commitment to both his ‘amazing ride’ and the MS movement is unique and inspiring to everyone impacted by multiple sclerosis,” commented Joyce Nelson, President & CEO of the National MS Society. “Many thanks to Phil Keoghan and GNC for their incredible efforts and for bringing us closer to crossing the finish line for a world free of MS.”

The National MS Society

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APS: Try Low-Back Rehab Before Invasive Procedures

LITTLE FALLS, N.J., May 15 -- Patients with chronic low-back pain should undergo interdisciplinary rehabilitation before clinicians try more invasive treatments, according to new guidelines from the American Pain Society (APS).

In addition, doctors should fully inform patients of the potential risks and benefits of invasive therapies, such as surgery, as part of a shared decision-making process, according to Roger Chou, M.D., of Oregon Health & Science University in Portland, director of the APS clinical practice guideline program.

In addition, he said, many invasive treatments are not backed by very strong evidence.

"There's been a tendency in the back pain world to adopt therapies based on what many would consider to be inadequate evidence," he said. "One of our hopes is that the guideline will help spur additional research so we really can understand which patients are likely to benefit and how to use the therapies appropriately."

He and his colleagues published the new guidelines in the May 1 issue of Spine.

In issuing guidelines that see invasive procedures as a last step, the researchers noted that more than half the patients who undergo surgery do not experience an "excellent" or "good" outcome (defined as no more than sporadic pain, slight restriction of function, and occasional analgesics). ...full report in MedPage Today

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Five Multiple Sclerosis Research Centres Established

In a move intended to significantly accelerate the pace of MS research, the Multiple Sclerosis Society of Canada announced the establishment of five research and training centres involving over 100 established scientists and 250 trainees.

The entities, dubbed endMS Regional Research and Training Centres (RRTC), come less than one year after the MS Society launched a major fundraising initiative to alter the research landscape in Canada. ....full report in Medical News Today

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What's new for 'Multiple Sclerosis' in PubMed

Coxsackie B meningoencephalitis in a patient with acquired immunodeficiency syndrome and a multiple sclerosis-like illness. - This is the first case report, to the best of our knowledge, of an enteroviral meningoencephalitis complicating human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). - J Neurovirol. 2009 May 14:1-6. [Epub ahead of print] in PubMed

Factors that influence adherence with disease-modifying therapy in MS. - This study characterizes factors that are associated with failure to fully adhere with disease modifying injection therapy for MS and underscores the principles associated with optimizing adherence and its implications for effective treatment of the disease process in MS. - J Neurol. 2009 Apr;256(4):568-76. Epub 2009 Apr 27. in PubMed

Multiple sclerosis patients' benefit-risk preferences: serious adverse event risks versus treatment efficacy. - Medical interventions carry risks of adverse outcomes that must be evaluated against their clinical benefits. Most MS patients indicated they are willing to accept risks in exchange for clinical efficacy. Patient preferences for potential benefits and risks can assist in decision-making. - J Neurol. 2009 Apr;256(4):554-62. Epub 2009 Apr 27. in PubMed

Glatiramer acetate and interferon beta-1b: a study of outcomes among patients with multiple sclerosis. - Results from this study indicate that users of GA have a significantly lower probability of 2-year relapse than users of IFN beta-1b. In addition, among continuous users, the 2-year total average direct medical costs are significantly lower for users of GA than for users of IFN beta-1b. - Adv Ther. 2009 May 14. [Epub ahead of print] in PubMed

Occurrence of ankylosing spondylitis and multiple sclerosis-like syndrome in a HLA-B27 positive patient. -Occurrence of multiple sclerosis (MS) in patients with ankylosing spondylitis (AS) has been reported in isolated cases. - Neurol Sci. 2009 May 15. [Epub ahead of print] in PubMed

A molecular trio in relapse and remission in multiple sclerosis. - This Review discusses how this molecular trio interacts to initiate relapses (in the case of osteopontin and alpha4beta1 integrin) and then to terminate them as remissions in multiple sclerosis (in the case of alphaB crystallin). -Nat Rev Immunol. 2009 May 15. [Epub ahead of print] in PubMed

Autoimmune T cell responses in the central nervous system. - Nat Rev Immunol. 2009 May 15. [Epub ahead of print] in PubMed

From genes to function: the next challenge to understanding multiple sclerosis. - These studies should proceed in parallel with the use of genetically defined human populations to explore how both genetic and environmental factors affect the function of the pathways in individuals with and without disease, and how these determine the inherited risk of multiple sclerosis. - Nat Rev Immunol. 2009 May 15. [Epub ahead of print] in PubMed

Drug therapies for the treatment of multiple sclerosis. - The article also discusses some of the most promising new compounds in clinical trials. - J Infus Nurs. 2009 May-Jun;32(3):137-44. in PubMed

Accelerated Course of Experimental Autoimmune Encephalomyelitis in PD-1-Deficient Central Nervous System Myelin Mutants. - Our data show that the interplay between immune dysregulation and myelinopathy results in a stable exacerbation of actively induced autoimmune CNS inflammation, suggesting that the combination of several pathological issues contributes significantly to disease susceptibility or relapses in human disease. - Am J Pathol. 2009 May 14. [Epub ahead of print] in PubMed

Responsiveness of patient-reported outcome measures in multiple sclerosis relapses: the REMS study. - The responsiveness of the MS-specific instruments was less than ideal. The MSIS-29 and the MSQOL-54 were significantly more responsive, using both distribution-based and anchor-based approaches, than FAMS, and should be preferred in longitudinal studies. - J Neurol Neurosurg Psychiatry. 2009 May 13. [Epub ahead of print] in PubMed

IFNbeta therapy progressively normalizes the increased ex vivo T lymphocyte apoptosis observed in active patients with multiple sclerosis. - In conclusion, IFNbeta therapy progressively normalizes the increased ex vivo T lymphocyte apoptosis observed in MS. However, it is not clear if this reduction in spontaneous T lymphocyte apoptosis is due to direct effect of IFNbeta or secondary to decreased clinical and sub-clinical activity. -Clin Immunol. 2009 May 12. [Epub ahead of print] in PubMed

Severe accidental overdose of 4-aminopyridine due to a compounding pharmacy error. - Emergency physicians should be familiar with the signs of 4-AP toxicity. Additionally, they should be aware that 4-AP and other non-FDA-approved medications may be available to patients from compounding pharmacies, and that quality control of made-to-order drug compounding may not be up to the standard that is expected with mass-produced pharmaceuticals. - J Emerg Med. 2009 May 12. [Epub ahead of print] in PubMed

Recombinant interferon-beta therapy and neuromuscular disorders. - Thus, recombinant IFNbeta has the theoretical potential to either treat or cause autoimmune neuromuscular disorders by altering the complicated and delicate balances within the immune system networks. - J Neuroimmunol. 2009 May 12. [Epub ahead of print] in PubMed

CSF oligoclonal band patterns reveal disease heterogeneity in multiple sclerosis. -
J Neuroimmunol. 2009 May 12. [Epub ahead of print] in PubMed

Neuroprotective and anti-inflammatory effects of estrogen receptor ligand treatment in mice. - Estrogens and estrogen receptor (ER) ligand treatments are promising treatments to prevent MS-induced neurodegeneration and a multicenter phase II clinical trial of estriol as a beneficial therapy in MS is underway. - J Neurol Sci. 2009 May 12. [Epub ahead of print] in PubMed

Blood Brain Barrier Compromise with Endothelial Inflammation may Lead to Autoimmune Loss of Myelin during Multiple Sclerosis. - We are optimistic that a hemodynamic approach to the multiple sclerosis pathogenesis can open a new chapter of investigations and treatment of this debilitating neurologic disease. - Curr Neurovasc Res. 2009 May;6(2):132-9. in PubMed

Adult neural stem cells for the treatment of neuroinflammation. - The application claims the use of aNSCs and multipotent somatic stem cells for the treatment of inflammation, associated with neurological diseases, disorders and injuries particularly, and for inducing tolerance to the immune central and/or peripheral system. - Expert Opin Ther Pat. 2009 Mar;19(3):373-6. in PubMed

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Thursday, May 14

BioMS Medical Announces First quarter 2009 results

EDMONTON, May 11 /CNW/ - BioMS Medical Corp. (TSX: MS), a leadingdeveloper in the treatment of multiple sclerosis (MS), today announcedfinancial and operational results for the first quarter, ended March 31, 2009.

"We remain on track to obtain the results from MAESTRO-01, the first ofour two pivotal trials evaluating dirucotide in patients with secondaryprogressive multiple sclerosis, in the second half of 2009," said Kevin Giese,President and CEO of BioMS Medical. "We have demonstrated in previous trialsthat dirucotide has shown to be well tolerated and has the capacity to slowthe progression of disease in certain genetically pre-disposed MS patients. Ifour pivotal trials confirm these results, we believe dirucotide couldrepresent the first drug with blockbuster potential for the treatment ofsecondary progressive multiple sclerosis."

Currently, BioMS is conducting two pivotal clinical trials and oneopen-label follow-on trial of dirucotide for the treatment of secondaryprogressive MS (SPMS):

- MAESTRO-01: On January 22, 2007, BioMS announced that this pivotal phase III trial, being conducted in Canada and Western Europe, had completed full recruitment of 611 SPMS patients at 47 trial sites in ten countries. The primary clinical endpoint for MAESTRO-01 (and MAESTRO-03) is defined as a statistically and clinically significant increase in the time to progression of the disease as measured by the Expanded Disability Status Scale (EDSS), in patients with HLA-DR2 and/or HLA-DR4 immune response genes.

On April 21, 2009 the DSMB conducted a scheduled safety analysis and recommended that the trial continue to completion. To date, there have been ten positive safety reviews from the Data Safety Monitoring Board (DSMB) and this was the final scheduled review by the DSMB prior to the completion of the trial. BioMS anticipates results from the trial will be reported in the second half of 2009.

- MAESTRO-02: Eligible patients who have successfully completed MAESTRO- 01 may choose to receive dirucotide on an un-blinded basis in this open-label follow-on study. To date, approximately 95% of the eligible patients who have successfully completed the MAESTRO-01 trial have enrolled in this follow-on study.

- MAESTRO-03: Enrollment was initiated in June 2007 and completed on August 1, 2008 for this pivotal U.S. phase III trial of approximately 510 SPMS patients at 67 sites across the U.S. To date, the DSMB has conducted four reviews of the data from this trial and recommended it continue. ....complete report from BioMS Medical Report

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APS: Low Back Pain Eased with Extended-Release Tapentadol

SAN DIEGO, May 13 -- Long-acting tapentadol, an experimental opioid, appears to relieve chronic low back pain more effectively than placebo, company researchers said here.

At 12 weeks, significantly higher percentages of patients taking tapentadol ER achieved a 30% improvement in pain intensity than patients taking placebo (P=0.001), Mila Etropolski, M.D., of Johnson and Johnson Pharmaceutical Research and Development in Raritan, N.J., reported at the American Pain Society meeting.

A significantly higher percentage also reached 50% improvement in pain intensity (P=0.016), Dr. Etropolski said.

"Tapentadol extended release also had a better tolerability profile and was associated with a lower rate of treatment discontinuations than controlled release oxycodone," she said.

In industrialized nations, chronic low back pain represents the most common cause of disability. According the National Institute of Neurological disorders and Stroke, Americans spend at least $50 billion each year on low back pain.

As many as 80% of Americans experience lower back pain in their lifetimes and as many as 8% of these individuals have chronic low back pain.

Tapentadol is an orally administered, centrally-acting analgesic that binds to mu-opioid receptors and inhibits norepinephrine reuptake. Although the exact mechanism of action is not known, these two mechanisms, which affect established pain pathways, are thought to be responsible for pain relief with tapentadol.

Longer-lasting opioids such as extended-release tapentadol may offer benefits for patients who will require narcotics to control chronic pain, said Carlton Dampier, M.D., of Emory University in Atlanta, a discussant for the study.

"It's easier for patients to take fewer pills," he said, which improves compliance with medical therapy and also smoothes out delivery of analgesia. "With opioids, patients often experience side effects such as dizziness and sleepiness" which can occur with each dosing.

"Efficacy results for extended-release tapentadol were more robust than controlled-release oxycodone," Dr. Etropolski said. "More conservative imputation methods failed to show significant differences between controlled-release oxycodone and placebo because of the high rate of discontinuation in the oxycodone group, particularly early in the study before meaningful pain relief was achieved."

An intermediate release formulation of tapentadol has been approved by the FDA, but the product has not yet reached pharmacies. The extended-release formulation is being developed by Johnson and Johnson. ....full report in MedPage Today

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Researchers Identify Pathway To Reactivate Myelin Repair

UMDNJ researchers have identified a key pathway that could lead to new therapies to repair nerve cells' protective coating stripped away as a result of autoimmune diseases such as Multiple Sclerosis (MS). An article reporting their findings will appear in the May 13 online edition of the Journal of Neuroscience.

Myelin is fatty material that coats and protects the ends of nerve cells. The loss of myelin and myelin-producing cells impairs the ability of nerves to conduct signals. A severe loss may lead to erosion of nerve tissues and result in permanent damage.

"In people with MS that is relapsing-remitting, the body can replace myelin that has been stripped away," explained Teresa L. Wood, Ph.D., the study's lead investigator. "But, after repeated attacks, that process of replacement no longer functions well," she added.

"Our data demonstrate that a novel cellular pathway, called the mammalian target of rapamycin (mTOR), regulates the generation of new myelin-producing cells (oligodendrocytes) and the production of myelin in immature rodent cells," Wood said. She is a professor in the Department of Neurology & Neurosciences and the Rena Warshow Chair in Multiple Sclerosis at the UMDNJ-New Jersey Medical School.

More work is needed to determine if the key to reactivate remyelination is to stimulate the pathway or if environmental impediments, such as inflammation, also must be overcome to allow the pathway to function normally. "Now at least we know a target to go after to promote repair," she said.

The researchers' work may also lead to new therapies for other disorders where the myelin-producing cells are affected, such as autism, Alzheimer's disease, and perinatal brain injury. ....Medical News Today

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New MS Drugs Growing In Popularity But Are They Increasing The Risk Of Cancer?

Current CIHR-funded research: In the first study of its kind, researchers from Canada are examining whether beta-interferon, widely used to treat multiple sclerosis (MS), increases the risk of cancer for MS patients.

"Given the increasing popularity of MS drugs, even a moderate increase in the risk of cancer could translate into a substantial number of new cancer cases," says lead researcher Dr. Helen Tremlett at the University of British Columbia. "Our study will also benefit from its independence from the pharmaceutical industry, which manufactures beta-interferon."

Did you know: Canada has one of the highest rates of MS in the world - as many as 75,000 Canadians have the disease. .....Medical News Today

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What's new for 'Multiple Sclerosis' in PubMed

The role of Cyclophilin D in learning and memory. - Hippocampus. 2009 May 12. [Epub ahead of print] in PubMed

Progressive multifocal leukoencephalopathy and relapsing-remitting multiple sclerosis: a comparative study. - There appear to be differences between the clinical and MRI characteristics of PML and RRMS, which may help distinguish new MS activity from PML. Magnetization transfer ratio studies may provide additional clues in improving early detection of PML in patients with preexisting MS and warrant further investigation. - Arch Neurol. 2009 May;66(5):593-9. in PubMed

A single, early magnetic resonance imaging study in the diagnosis of multiple sclerosis. - A single brain MRI study that demonstrates DIS and shows both gadolinium-enhancing and nonenhancing lesions that suggest DIT is highly specific for predicting the early development of CDMS, even when the MRI is performed within the first 3 months after the onset of a CIS. - Arch Neurol. 2009 May;66(5):587-92. in PubMed

Diffusely abnormal white matter in chronic multiple sclerosis: imaging and histopathologic analysis. - This study classifies DAWM in chronic MS as an abnormality that is different from normal-appearing WM and focal WM lesions, most likely resulting from the cumulative effects of ongoing inflammation and axonal pathology. As such, DAWM is likely to substantially contribute to disease progression and may prove to be an important new disease marker in clinical trials focusing on the neurodegenerative aspects of MS. - Arch Neurol. 2009 May;66(5):601-9. in PubMed

MRI features of benign multiple sclerosis: toward a new definition of this disease phenotype. - It is well known that the current classification of patients with benign multiple sclerosis (BMS), i.e., those with absent or minimal locomotor disability several years after disease onset, suffers from not having any prognostic value for the subsequent evolution of multiple sclerosis (MS). - Neurology. 2009 May 12;72(19):1693-701. in PubMed

[Safety and tolerability in the early phase of slow schedule versus fast schedule treatment with 44 micrograms of interferon beta-1a in patients with multiple sclerosis (PARALEN study).] - Interferon (IFN) beta-1a, 44 micrograms, administered three times a week (tiw), is the recommended dose in 'relapsing' multiple sclerosis. During the clinical practice, physicians initiate treatment either with this complete dose, or with escalating dose. AIM. To determine safety of IFN beta-1a 44 micrograms tiw, comparing a complete dose initiation regimen versus an escalating dose initiation. - Rev Neurol. 2009 May 16-31;48(10):505-8. in PubMed

Is multiple sclerosis a generalized disease of the central nervous system? An MRI perspective. - At present, it is not possible to determine whether lesion formation, or a more diffuse process, is the principal pathological event in MS. - Curr Opin Neurol. 2009 Jun;22(3):214-8. in PubMed

Emerging multiple sclerosis disease-modifying therapies. - Several of the emerging therapies focusing on immune-mediated disease mechanisms seem to offer stronger efficacy than the currently approved immune modulators for MS, although with potential for serious adverse effects. These therapies have also broadened our understanding of MS pathophysiology by demonstrating that significant decreases in new disease activity can be achieved through targeting of distinct cell types and mechanisms. - Curr Opin Neurol. 2009 Jun;22(3):226-32. in PubMed

Pediatric central nervous system inflammatory demyelination: acute disseminated encephalomyelitis, clinically isolated syndromes, neuromyelitis optica, and multiple sclerosis. - Although clinical definitions, increased awareness, and MRI have contributed to the increasing identification of acute demyelination and MS in children, challenges remain in predicting MS risk. Identification of reliable biomarkers or application of more advanced neuroimaging techniques would serve as invaluable tools to distinguish monophasic demyelination from the first attack of MS. - Curr Opin Neurol. 2009 Jun;22(3):233-40. in PubMed

Different white matter lesion characteristics correlate with distinct grey matter abnormalities on magnetic resonance imaging in secondary progressive multiple sclerosis. - Axonal transection within lesions with secondary degeneration into the grey matter may explain the relationship between T1 lesions and grey matter fraction. A parallel accumulation of demyelinating lesions in white and grey matter may contribute to the association of T2 lesion volume and lesion MTR with grey matter MTR. - Mult Scler. 2009 May 12. [Epub ahead of print] in PubMed

Accumulation of cortical lesions in MS: relation with cognitive impairment. - Cortical lesions increase significantly over a 3-year time period, are most frequent in SP patients, and are associated with cognitive impairment. - Mult Scler. 2009 May 12. [Epub ahead of print] in PubMed

Magnetization transfer ratio abnormalities reflect clinically relevant grey matter damage in multiple sclerosis. - GM damage was related to long-term disability in an MS cohort with a relatively low median EDSS. Markers of intrinsic GM damage (MTR) and tissue loss offer clinically relevant information in MS. - Mult Scler. 2009 May 12. [Epub ahead of print] in PubMed

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Tuesday, May 12

Cassidy: Software allows disabled to work on computers

For Christine Bakanoff-Adams and Gloria Kaswen too much of life has been about loss.

Losing vision. Losing the use of their legs, then not being able to use their arms and ultimately not being able to work their hands.

Bakanoff-Adams, 35 of Capitola, says she showed the first symptoms of multiple sclerosis at age 9. Kaswen, 55 of Watsonville, was in her early 20s when she was first told she had MS.

Symptoms would come and go until they just kept coming one after another without remission.

"Each time it makes me sad," Kaswen says of the setbacks. "I went through a mourning, grieving period for about 10 years before I got to where I am emotionally."

But the two women have something in common besides MS something that is helping them get something back, something that is about gaining something new.

Both Bakanoff-Adams and Kaswen were referred by therapists at Domincan Hosptial in Santa Cruz to Jon Bjornstad, an independent software consultant in town who has built a remarkable program that allows quadriplegics to use a computer to do the things many of us do without a second thought.

Bjornstad sees software as an art form. He believes carefully crafted lines of code can possess the power to transform lives..

"I'm an artist," says Bjornstad, a studious-looking 59-year-old. An artist who writes code because it brings him joy. His masterwork is something he calls Sue Center, named for Sue Simpson, a paralyzed woman whom Bjornstad volunteered to help with technology issues in the 1980s. Bjornstad was eventually inspired to come up with his own software solution to her tech travails. Simpson has since died, but Bjornstad has continued to improve Sue Center, http://www.suecenter.org/, and evangalize for his complex program. He says he's written more than 15,000 lines of code in the Perl programming language to date and more improvements could be coming.......full story in The Daily News (Los Angeles)

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2 Drug stocks rose from the Dead, another is Poised to do the same.

DUBLIN, April 29 (Reuters) - Elan's (ELN.I) Tysabri drug may be able to reverse damage caused by multiple sclerosis, the Irish drugmaker and its U.S. partner Biogen Idec (BIIB.O) said on Wednesday, boosting Elan's shares 10 percent.

Data released by the companies at the American Academy of Neurology showed Tysabri promoted the regeneration of the protein coat that protects nerve fibres and whose damage causes the symptoms of multiple sclerosis.

But sales have been crimped because of its link with progressive multifocal leukoencephalopathy, or PML, a potentially deadly brain infection.

Elan's shares have lost almost three-quarters of their value over 12 months due to concerns over the safety of Tysabri, disappointing results from a trial of its experimental Alzheimer's vaccine and uncertainty over its future.

Its stock traded 10 percent higher by 0911 GMT at 4.8 euros, outperforming a 3 percent stronger wider Irish market .ISEQ.

Elan said last week it was seeking a partnership with a big pharmaceutical company, after reporting a 14 percent rise in first-quarter revenue and a wider net loss.

Swiss drugmaker Novartis AG (NOVN.VX) and Germany's Merck KGaA (MRCG.DE) are leading the charge to develop multiple sclerosis drugs that can be taken orally, rather than by infusion or injection. (Reporting by Andras Gergely; Editing by David Cowell) ....full report in The Motley Fool

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Staying Ahead of MS

JACKSONVILLE, Fla. (Ivanhoe Newswire) -- It's a debilitating disease that wreaks havoc on the central nervous system and can rob a person of the ability to walk. Up to 350,000 people in the United States have multiple sclerosis (MS), and 200 new cases are diagnosed each week. An experimental drug holds promise for people hoping to hold on to their mobility.

A 38-year-old attorney, Allison Keller is in the race of her life.

"I would get all sorts of electrical symptoms just shooting up and down my legs and my back," Keller told Ivanhoe.

She blamed it on being a busy, working mom -- until she got the diagnosis: multiple sclerosis.
"I immediately had visions of being in a wheelchair," Keller said.

Other attacks followed -- numbness in her hands, blurry vision and vertigo. She started a drug regimen … and started doing her homework.

"I read the New England Journal of Medicine, obviously highly respected, and read that it basically had a 70 percent better rate than the top medicine out there," Keller said.

Allison's talking about Campath, a chemotherapy drug tested in people with relapsing-remitting MS, the most common form, where patients have unexpected attacks. The study found it lowered the disability rate by 71 percent and the relapse rate by 74 percent compared to other treatments.

"Before we had these drugs fighting with each other, am I 2 percent better, am I even 10 percent better? But 70 percent better is a lot better," Daniel Kantor, M.D., Director of the University of Florida's Comprehensive Multiple Sclerosis Center in Jacksonville, Fla., told Ivanhoe.

Patients get infusions for five days straight. It pushes down the white blood cell count so they can't attack the nervous system.

"Now, anything new, you have to be a little hesitant about," Dr. Kantor said.

Risks include developing thyroid disease and bleeding in the brain. Keller wasn't eligible for the trial, so she's taking the drug off-label, meaning it's not FDA-approved for MS.

"It kind of struck us that if we want this, we're going to have to take some risks," she said. Keller is excited about her progress. "I'd say within 6 weeks, all of the MS symptoms, except for some of the hand [symptoms], are gone," she said.

She's a mom gambling on an experimental treatment to save her from future with MS.

Campath is currently in phase III trials for MS treatment. Dr. Kantor says if they're successful, the cancer drug could be approved for the disease within the next three to four years.

Ivanhoe Broadcast News: Medical Breakthroughs

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Injection Eases Opioid-Induced Constipation

SAN DIEGO, May 12 -- Subcutaneous injections of methylnaltrexone (Relistor) can relieve constipation caused by opioid treatment for noncancer pain -- often within four hours -- researchers said here

"As many as 40% of people who are taking opioids for pain relief experience constipation that is severe enough to cause major limitations to their quality of life," said E. Richard Blonsky, M.D., director of the Pain and Rehabilitation Clinic of Chicago and clinical professor of neurology at Northwestern University's Feinberg School of Medicine. ....full report in MedPage Today

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Ability to problem solve influenced by your movement

Swinging their arms helped participants in a new study solve a problem whose solution involved swinging strings, researchers report, demonstrating that the brain can use bodily cues to help understand and solve complex problems.

The study, appearing in an upcoming issue of the journal Psychonomic Bulletin & Review, is the first to show that a person's ability to solve a problem can be influenced by how he or she moves.

"Our manipulation is changing the way people think," said University of Illinois psychology professor Alejandro Lleras, who conducted the study with Vanderbilt University postdoctoral researcher Laura Thomas, his former graduate student. "In other words, by directing the way people move their bodies, we are - unbeknownst to them - directing the way they think about the problem."

The new findings offer new insight into what researchers call "embodied cognition," which describes the link between body and mind, Lleras said........full report in The Medical News

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What's new for 'Multiple Sclerosis' in PubMed

Pharmacotherapy for multiple sclerosis: Progress and prospects. - Because of the inadequacy of current treatment options, there is a need for the development of more effective disease-modifying therapies (eg, sodium channel blockers), along with new drugs to treat specific symptoms of MS, such as fatigue. - Curr Opin Investig Drugs. 2009 May;10(5):407-17 in PubMed

Persistent signaling induced by FTY720-phosphate is mediated by internalized S1P1 receptors. - Targeting sphingosine-1-phosphate receptors with the oral immunomodulator drug FTY720 (fingolimod) has demonstrated substantial efficacy in the treatment of multiple sclerosis. - Nat Chem Biol. 2009 May 10. [Epub ahead of print] in PubMed

Superficial siderosis of central nervous system mimicking multiple sclerosis. - The demonstration of CSF oligoclonal bands in the reported patient implies that inflammation might be involved in the pathogenesis of superficial siderosis. The diagnosis of this newly recognizable entity needs a high clinical suspicion, but further research is needed to fully elucidate the involved mechanisms. - Neurologist. 2009 May;15(3):153-5. in PubMed

In search of human oligodendroglia for myelin repair. - In this review, we present recent advances in the field and discuss the various strategies that helped overcome the challenge of human oligodendroglial differentiation. - Neurosci Lett. 2009 Jun 12;456(3):112-9. Epub 2009 Jan 21. in PubMed

Regeneration and repair in multiple sclerosis: the role of cell transplantation. - This review will focus on the therapeutic efficacy of different sources of somatic stem cells - and in particular on those of neural origin - in promoting CNS repair in a chronic (auto)immune-mediated inflammatory disorder such as multiple sclerosis. - Neurosci Lett. 2009 Jun 12;456(3):101-6. Epub 2009 Jan 17. in PubMed

A Symbol Digit Modalities Test version suitable for functional MRI studies. - These may provide the basis for future studies assessing potential abnormal cortical activations in multiple sclerosis patients and other clinical populations. -Neurosci Lett. 2009 May 29;456(1):11-4. Epub 2009 Mar 31. in PubMed

Statins: Mechanisms of neuroprotection. - In this article, we review the current data on the neuroprotective effects of statins and their underlying mechanisms. -Prog Neurobiol. 2009 May;88(1):64-75. Epub 2009 Feb 21. in PubMed

EBV in MS: guilty by association? - Although no data so far unequivocally support a direct etiologic role of the virus, recent studies allow for the development of testable hypotheses as to how EBV infection potentially promotes autoimmunity and central nervous system (CNS) tissue damage in MS. - Trends Immunol. 2009 May 8. [Epub ahead of print] in PubMed

Lack of TIMP-1 increases severity of experimental autoimmune encephalomyelitis: Effects of darbepoetin alfa on TIMP-1 null and wild-type mice. - J Neuroimmunol. 2009 May 8. [Epub ahead of print] in PubMed

Variants in ST8SIA1 do not play a major role in susceptibility to multiple sclerosis in Canadian families. - J Neuroimmunol. 2009 May 8. [Epub ahead of print] in PubMed

Incidence and factors associated with treatment failure in the CLIMB multiple sclerosis cohort study. - These observations demonstrate that treating physicians use both clinical and MRI parameters to define a response to treatment and initiation of a treatment change and that baseline MRI identified those with increased risk of treatment failure. - J Neurol Sci. 2009 May 8. [Epub ahead of print] in PubMed

Oral contraceptives and the risk of multiple sclerosis: A review of the epidemiologic evidence. - In this article, we review the methodology and results of published epidemiologic studies addressing this issue. On the whole, the existing epidemiologic evidence does not support an important effect of oral contraceptive use on the risk of MS, though it does suggest that oral contraceptives might delay the onset of the disease. - J Neurol Sci. 2009 May 7. [Epub ahead of print] in PubMed

Glatiramer acetate treatment in PPMS: Why males appear to respond favorably. - The analyses conducted do not support a treatment by gender interaction for GA in either PPMS or relapsing forms of MS. Nor could we find consistent precedence in the literature for important effects of gender on outcome, recognizing that such effects have not always been carefully sought. It remains reasonable to consider that there exist differences in the rates of clinical disease progression between men and women with MS that should be better studied. - J Neurol Sci. 2009 May 7. [Epub ahead of print] in PubMed

Sex hormones, brain damage and clinical course of Multiple Sclerosis. - Both data in experimental models and patient studies discussed in this review encourages a gender-based approach to MS. - J Neurol Sci. 2009 May 6. [Epub ahead of print] in PubMed

Cerebrospinal fluid biomarkers in Multiple Sclerosis. - A brief update on possible CSF biomarkers that might reflect key pathological processes of MS such as inflammation, demyelination, neuro-axonal loss, gliosis and regeneration is provided. - Neurobiol Dis. 2009 May 5. [Epub ahead of print] in PubMed

Molecular mechanisms of T-cell receptor and costimulatory molecule ligation/blockade in autoimmune disease therapy. -Immunol Rev. 2009 May;229(1):337-55. in PubMed

The Treatment of Multiple Sclerosis with Inosine. - These data suggest that the use of inosine to raise serum UA levels may have benefits for at least some MS patients. The effect of this treatment is likely to be a consequence of inactivation of peroxynitrite-dependent free radicals. Close monitoring of serum UA levels as well as other measures are required to avoid the potential development of kidney stones. - J Altern Complement Med. 2009 May 8. [Epub ahead of print] in PubMed

Effect of MOG sensitization on somatosensory evoked potential in Lewis rats. - J Neurol Sci. 2009 May 5. [Epub ahead of print] in PubMed

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Monday, May 11

ARVO: Vision Compromised in MS Even Without Symptoms

FORT LAUDERDALE, Fla., May 8 -- Researchers here suggested that deterioration of vision occurs in multiple sclerosis patients even without clinical manifestations such as optic neuritis.

University of Pennsylvania physicians told colleagues to consider having MS patients undergo regular testing for vision loss, with specific concentration on advanced tests for low-contrast acuity.

"Our findings suggest there is subclinical axonal loss in the anterior vision pathways of patients with multiple sclerosis that occurs without symptoms," said Esther Bisker, M.D., a resident in neurology.

In fact, she said, researchers found worsening of low-contrast acuity in 29% of the eyes with a history of optic neuritis and a statistically comparable 35% of eyes with no such history. Hence, the need for advance testing.

"The emergence of optical coherence tomography has allowed us to capture the unique structure-function correlations provided by the anterior visual pathway in multiple sclerosis," Dr. Bisker said in a presentation at the Association for Research in Vision and Ophthalmology.

"Our study indicates that these tests should be performed among all patients diagnosed with multiple sclerosis, not just those with a history of vision complications," she said.

Dr. Bisker and colleagues followed 1,011 patients in the multiple sclerosis treatment programs at the University of Pennsylvania, Johns Hopkins, and The University of Texas Southwestern Medical School in Dallas.

"The underlying disease is continually wearing away the nerve 'wiring,' and that is going to cause problems anywhere in the body," said Dr. Connor, who is director of research at the college. ....full report in MedPage Today

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MS Society Statement On Oral Therapy Results

Following the embargoed news released by the Queen Mary University of London concerning the oral MS drug cladribine and the results due to be presented at the American Academy of Neurology meeting, please find below a statement from the MS Society.

Dr Lee Dunster, Head of Research at the MS Society, said: "These are remarkable results and being able to take a tablet instead of having injections will be a huge step forward for people with MS.

"The evidence is there, but we now need to see cladribine move smoothly through the regulatory process and the price the manufacturer sets will play a crucial part in that."

This week is MS Week. For more info, go to http://www.msweek.org.uk

full report in Medical News Today

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The Global Spread of Multiple Sclerosis

It is hard to get a good sense of the spread of multiple sclerosis in some parts of the world. Last summer, the BBC reported on a survey of multiple sclerosis internationally. They have a great map that shows multiple sclerosis prevalence worldwide (the MS Global Map). It is very interesting how well that map "maps" onto the the Anglo-European world. The US, UK, Canada and Northern European countries dominate the map.

They also report on the lack of knowledge and information about multiple sclerosis in some countries, to the point that people with multiple sclerosis experience stigma and are shunned because people think the illness is contagious or the result of "sins in a past life."

Multiple Sclerosis Blog By Julie Stachowiak, Ph.D.,
About.com Guide to Multiple Sclerosis

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Imaging outcomes for neuroprotection and repair in multiple sclerosis trials

In this Review, we examine the potential of traditional and novel imaging parameters to serve as primary outcomes in phase II clinical trials of neuroprotective and reparative strategies in MS. We present the conclusions of an international meeting of imaging, clinical and statistical experts, as well as a review of relevant literature...........Nature Review Neurology

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Saturday, May 9

What's new for 'Multiple Sclerosis' in PubMed

[Health-based driver's licence renewal] - The group of patients referred for renewal of driver's licence because of illness or impairment is heterogeneous and in most cases the result is a time-restricted driver's licence. - Ugeskr Laeger. 2009 Apr 27;171(18):1509-13. in PubMed

Corpus callosum function in verbal dichotic listening: Inferences from a longitudinal follow-up of Relapsing-Remitting Multiple Sclerosis patients. - Brain Lang. 2009 May 4. [Epub ahead of print] in PubMed

Interferon-beta therapy up-regulates BDNF secretion from PBMCs of MS patients through a CD40-dependent mechanism. - J Neuroimmunol. 2009 May 4. [Epub ahead of print] in PubMed

Neurobiological mechanisms underlying emotional processing in relapsing-remitting multiple sclerosis. - Overall our findings offer new insights into the neurobiological mechanisms of emotions in multiple sclerosis and provide evidence that they resemble those described for some psychiatric disorders. - Brain. 2009 May 6. [Epub ahead of print] in PubMed

Greater loss of axons in primary progressive multiple sclerosis plaques compared to secondary progressive disease. - More extensive axonal loss within areas of demyelination in primary progressive multiple sclerosis could explain high levels of axonal loss observed in these patients despite low levels of demyelination. - Brain. 2009 May;132(Pt 5):1190-9. in PubMed

Multiple sclerosis associates with LILRA3 deletion in Spanish patients. - Genes Immun. 2009 May 7. [Epub ahead of print] in PubMed

Absenteeism and health-benefit costs among employees with MS * - The purpose of this analysis was to assess the differences in lost time and health-benefit costs (HBCs) among employees treated with disease modifying treatments (DMTs) for multiple sclerosis (MS). -Curr Med Res Opin. 2009 May 7. [Epub ahead of print] in PubMed

Cost effectiveness and budget impact of natalizumab in patients with relapsing multiple sclerosis. - Natalizumab was the most cost-effective therapy as measured by total cost per relapse avoided, not withstanding a higher drug acquisition cost versus other DMTs. Entry of natalizumab to the market is likely to result in a minimal increase in health-plan costs on a PMPM basis. Limitations of the study include the use of a surrogate measure, relapse avoided, as an outcome measure; also, adverse events were not included in the model. - Curr Med Res Opin. 2009 May 7. [Epub ahead of print] in PubMed

Effect of BEMER Magnetic Field Therapy on the Level of Fatigue in Patients with Multiple Sclerosis: A Randomized, Double-Blind Controlled Trial. - In this pilot study, we were able to demonstrate a beneficial effect of BEMER intervention on MS fatigue. As this was only a pilot study, trials with more patients and longer duration are mandatory to describe long-term effects. -J Altern Complement Med. 2009 May 7. [Epub ahead of print] in PubMed

Effects of the PPAR-beta agonist GW501516 in an in vitro model of brain inflammation and antibody-induced demyelination. - J Neuroinflammation. 2009 May 7;6(1):15. [Epub ahead of print] in PubMed

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United Spinal Association Reports Positive Results of Stem Cell Transplantation to Treat Multiple Sclerosis: Study May be Key to Unlocking a Cure

NEW YORK, May 8 /PRNewswire-USNewswire/ -- An article published in the Summer 2009 edition of Multiple Sclerosis Quarterly Report, a joint publication of United Spinal Association (www.UnitedSpinal.org) and the North American Research Committee on Multiple Sclerosis (NARCOMS), highlights the positive initial results of patients who have improving neurologic function after receiving a stem cell transplant, despite no longer taking any MS medications.

The results are reported in a National Institutes of Health (NIH)-sponsored study called HALT-MS to confirm whether high-dose immunosuppression followed by autologous stem cell transplantation will prevent MS attacks in patients who are not responding to available treatment options and ultimately protect against the degeneration of nerve fibers.

The article, written by George H. Kraft, MD, MS, director of the Western MS Center in Seattle, Washington, and colleagues, reveals the promising outcomes of the first three patients entered into the HALT-MS Study, including a 27-year-old woman with an 8-year history of relapsing MS who was treated with five different MS drugs, but continued to have relapses.

The study involves wiping out the patient's immune system through high-dose chemotherapy or other means, such as radiation, to destroy most blood cells and bone marrow. Blood "stem cells" with the capacity to generate new blood and immune cells are then transplanted into the patient.

These stem cells can either be the patient's own or those from a matched donor. Once the cells are transplanted, they repopulate the bone marrow and restart building all the cell types found in the blood, a process called "engraftment". After transplantation, the patient would effectively have a "new" immune system that would not attack nerves in the brain and spinal cord as seen in MS.

Currently, there are approximately 400 patients with MS worldwide who have been treated with stem cell transplantation. Research demonstrates that patients with highly active forms of relapsing-remitting MS have responded best to treatment.

The Halt-MS Study is taking place at four centers in the US: The Fred Hutchinson Cancer Research Center/University of Washington Western MS Center; Ohio State University; Baylor College of Medicine; and M.D. Anderson Cancer Center, and is currently open to participants with severe relapsing forms of MS. For more information, visit HALT-MS Website or contact Bernie McLaughlin, RN at (206) 667-4916.

About United Spinal Association
United Spinal is a national 501(c)(3) non-profit membership organization formed in 1946 by paralyzed veterans and is dedicated to improving the quality of life for all Americans with spinal cord injuries, multiple sclerosis, spina bifida, ALS and post polio. It has played a significant role in writing the Americans with Disabilities Act, made important contributions to the Fair Housing Amendments Act and the Air Carrier Access Act. Membership is free and is open to all individuals with spinal cord disorders.

Available Topic Expert(s): For information on the listed expert(s), click appropriate link.
https://profnet.prnewswire.com/Subscriber/ExpertProfile.aspx?ei=83457

PRNewswire

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Thursday, May 7

Gray Matter Under Attack In Multiple Sclerosis: Protein Could Provoke Immune Attack On Several Cell Types

ScienceDaily (May 7, 2009) — Autoimmune disease is a condition in which the immune system attacks the body’s own material just as aggressively as it would attack a foreign pathogen. Multiple sclerosis, MS for short, is just one such autoimmune disease, and is one of the most common neurological diseases in the 20 to 30 years age group. The disease can have very severe consequences for those afflicted, since the body’s defenses attack the central nervous system.

It has long been assumed that myelin is the most important target for the misdirected immune response. This white, fat-rich protective layer of specialized cells enshrouds the long extensions of neurons. However, the central nervous systems of MS patients also exhibit damage in the gray matter, where the nerve cell bodies are located. How the patient’s disability develops depends greatly on the damage of the gray matter.

An international group headed by medical scientist Professor Edgar Meinl of LMU Munich has now discovered a possible connection: The protein Contactin-2 is produced both in the myelin sheathing and by neurons in the gray matter – and is attacked by misdirected immune factors. “Our results suggest that these processes also play a role in MS patients,” says Meinl. “It could even be that proteins existing both in myelin and in the gray matter are in fact the critical points of attack.”.....full story in ScienceDaily

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Fast Forward, LLC, Seeking Proposals in Early Stage Drug Development for MS

Proposals sought from academic institutions and seed-to-early stage companies developing novel therapeutic approaches to prevent, treat or reverse nervous system damage in multiple sclerosis

Fast Forward, LLC, a wholly-owned subsidiary of the National MS Society, and EMD Serono, Inc., an affiliate of Merck KGaA, Darmstadt, Germany, today announced a commitment of $3 million in 2009 to support innovative early-stage projects directed towards the development of therapies to prevent treat, or reverse nervous system damage in MS. This is the first "Request for Proposals" (RFP) issued under the auspices of a multi-year collaboration between Fast Forward and EMD Serono to accelerate innovation and commercial development of MS therapies. Merck KGaA, the parent corporation of EMD Serono, Inc., will provide up to $19 million in total funding for the collaboration.

“Our goal is to accelerate the discovery and commercial development of innovative MS therapies and bring these new and improved treatments to the people with MS who need them,” reported Dr. Timothy Coetzee, President of Fast Forward. “A unique feature of this RFP is that EMD Serono will be poised to work with award recipients to aggressively move their research programs forward.”

This RFP will complement Fast Forward’s ongoing research funding programs wherein it has established a strong presence in early-stage drug discovery for MS. Fast Forward will continue to provide critical resources for underfunded academic institutions and seed-to-early-stage companies engaged in innovative research in support of its commitment to end multiple sclerosis.

“EMD Serono is pleased to join forces with Fast Forward to drive the development of a new generation of MS therapies,” said Steve Arkinstall, Vice President, US Research, EMD Serono, Inc. “By providing university researchers and early-stage companies with an opportunity for follow-on funding and continued collaboration, we can close the gap between the laboratory discoveries and life changing therapies for people with MS.”

Fast Forward is seeking proposals for funding through the Accelerating Innovation and the Accelerating Commercial Development programs. The Accelerating Innovation program is open to academic institutions, non-profit research organizations, and seed- stage for-profit commercial organizations. The Accelerating Commercial Development program is open to early-stage for-profit commercial organizations that have achieved Series A or comparable investment funding.

Priority research areas for this RFP include:
• modulation of innate and/or adaptive immunity to promote central nervous system (CNS) neuroprotection and/or repair;
• molecular strategies for direct CNS neuroprotection;
• molecular approaches for CNS repair and remyelination;
• regenerative cell therapies and related platform technologies.
National Multiple Sclerosis Society

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Fast Forward, LLC and Provid Pharmaceuticals Announce Partnership for Development of PV-267, A Unique Compound Intended to Redirect the Abnormal Immun

New York, USA and North Brunswick, NJ, May 5, 2009 – Provid Pharmaceuticals, Inc, a drug discovery company, and Fast Forward, LLC, the National Multiple Sclerosis Society’s subsidiary devoted to bridging the gap between research and drug development, today announced a partnership to support Provid’s preclinical studies of PV-267. This novel compound is designed to redirect the abnormal immune response associated with multiple sclerosis (MS).

The agreement with Provid is the second in a series of partnerships between Fast Forward and early stage biotechnology companies. “We are pleased to partner with Provid to accelerate the development of new treatments for MS,” said Dr. Timothy Coetzee, President of Fast Forward. “PV-267 represents an innovative approach to inhibiting key pathways in the immune system in MS.” Adds Dr. Coetzee “Given the enormous challenges associated with drug development for MS relative to other diseases it is vital that we use Fast Forward’s resources to seed as many high quality commercial research programs as possible. PV-267 fits our profile for an innovative early stage opportunity.”

The National Multiple Sclerosis Society funds research in a range of scientific areas including immune mechanisms, genetics, nerve regeneration, and symptom managements. The agreement with Provid is a part of the Society’s Fast Forward initiative through which Fast Forward will partner with early stage biotechnology and pharmaceutical companies to develop treatments, diagnostics, medical devices, and related technologies to treat, reverse, and ultimately cure MS. Under terms of the agreement, Fast Forward will provide Provid with funds to support pre-clinical studies with PV-267 in collaboration with Dr. Thomas Forsthuber at the University of Texas at San Antonio. In addition, Fast Forward will receive warrants for purchase of shares in the company.

“Fast Forward’s support of the PV-267 program provides a strong, independent validation of our approach to the treatment of MS,” said Dr. Gary Olson, President and CEO of Provid. “We are very pleased to partner with a world leader in MS research to help us move PV-267 from the laboratory into development.”
National Multiple Sclerosis Society

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Obama’s Choice to Lead F.D.A. Doesn’t Shy Away From Difficult Situations

WASHINGTON — Appointed in 1991 to serve as acting health commissioner of New York City, Dr. Margaret A. Hamburg inherited urgent problems, a spare budget and a divided and demoralized staff.

The Food and Drug Administration could have a familiar feel for her.

The turnaround that she engineered is exactly what the Obama administration is hoping she will achieve at the drug agency, which is reeling from a host of similar problems.

On Thursday, the Senate Health, Education, Labor and Pensions Committee will consider whether to confirm Dr. Hamburg as F.D.A. commissioner. The hearing was moved up a week in the wake of the swine flue outbreak, which has given her nomination urgency. She is expected to be confirmed.

Although she lacks deep experience in drug- or food-safety issues, Dr. Hamburg was an infectious disease researcher and is an expert in bioterrorism and public preparedness, both of which seem keenly relevant. Her leadership in New York has won her admirers among public health advocates, many of whom said she would be a good leader to an agency a previous commissioner had likened to a cancer patient.

The Food and Drug Agency regulates more than $1 trillion worth of consumer goods, including a third of all imported goods. It is widely thought to need major reforms, particularly to its oversight of food safety. An unusual group of internal whistle-blowers has claimed that the agency’s oversight of medical devices is deeply flawed.

Dr. Hamburg was born to tackle such problems, said her mother, Dr. Beatrix Hamburg. Her father is a former president of the Institute of Medicine. Shortly after Margaret Hamburg’s second birthday, her mother learned that her daughter had a fiercely independent streak and “was just not going to be pushed around,” Dr. Beatrix Hamburg said.

So her mother, a psychiatrist, gave her daughter difficult tasks with significant obstacles. “She took to it like a duck to water,” Dr. Beatrix Hamburg said. Dr. Margaret Hamburg has been tackling difficult tasks ever since.

As a teenager, Dr. Hamburg spent a semester in Africa working with the renowned primatologist Jane Goodall. She has two children. She attended Harvard with her husband, Peter Brown, a mathematician and financial analyst.

Family, friends and coworkers all describe Dr. Hamburg as bright, funny and unusually calm. Dr. David Hamburg told of a speech his daughter was scheduled to give in New York City two years ago. Just before the talk, Dr. Hamburg’s husband called to tell her that their house had caught fire, although there were no injuries. She delivered the speech anyway.

“You would have never known that anything was wrong in her life,” Dr. David Hamburg said in an interview. “That’s vintage Peggy. She can carry on in a cool, organized way under heavy pressure.”.....full article in the New York Times

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MS fight is a constant battle

GARNER — Garner resident Jody Thada said she wouldn’t wish multiple sclerosis on her worst enemy.

Diagnosed with the debilitating disease of the central nervous system in 1994, Thada, now 48, said her experience with MS has been “one thing after another.”“

I’ve lost so much weight and muscle strength that I can’t walk real well,” she said. “It’s harder to talk, harder to eat, harder to swallow. I fall a lot.”

Worst of all, “There’s no answer as to why it’s happening and nothing to do for it.”

Thada has endured a routine of self-administered daily shots and hospital IV therapy.

She has taken prednisone and numerous other pills and medications. “For a while I was taking every vitamin there was,” she said.

Although she once prided herself on never being sick, she finds herself routinely getting sick.“I am in the (emergency room) a lot,” she said.

A member of a local MS support group, Thada has participated in all 11 of the MS walks in Mason City.

She goes door-to-door collecting donations to help in the fight against MS.“Just going around and introducing people to MS was an important thing for me,” she said.“

People didn’t know what it was.” Now walking with the aid of a cane, Thada will attend the event again this year, but has decided she can no longer do the walk.

“I want to show my support,” she said. “It’s important to raise money for research.”

Story in the Globe Gazette

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Acorda Leaps After U.S. FDA Gives Review to MS Pill (Update1)

May 6 (Bloomberg) -- Acorda therapeutics Inc. gained the most in two weeks in Nasdaq trading after saying U.S. regulators will review its multiple sclerosis drug Fampridine-SR under an expedited process.

The shares rose $3.31, or 17 percent, to $22.81 at 4 p.m. New York time in Nasdaq Stock Market composite trding. Acorda, based in Hawthorne, New York, reapplied on April 23 to the Food and Drug Administration for approval to sell ampridine.

Acorda is racing Biogen Idec Inc., Merck KGaA and Novartis AG to sell the first pill for multiple sclerosis, a disease now managed by injected medicines with $6 billion a year in worldwide sales. Acorda said the FDA will expedite its review of Fampridine as a “priority,” a process that typically takes six months, compared with 10 months for typical new drug applications.

“The priority review is a positive surprise,” said Phil Nadeau, an analyst with Cowen & Co. in New York, in a note to clients today.

Acorda received a “refuse to file” letter from the FDA on March 30. The agency sends such letters to companies whose new drug applications are incomplete, according to the FDA Web site. .........Bloomberg.com

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Fat Stem Cells to Treat Multiple Sclerosis?

A veterinarian, Dr. Robert Harman, has treated over 3500 horses and 1500 dogs with stem cells derived from fat tissue. These animals have been treated for inflammatory and autoimmune conditions such as arthritis, as well as various cartilage and bone injuries.

Now a company called Medistem is using this technology as a treatment for multiple sclerosis (according to a press release). A study published in the Journal of Translational Medicine presents three patients with multiple sclerosis who received this treatment. Essentially, the stem cells are harvested through liposuction and the risks seem to be much lower than other available stem cell treatments. As it turns out, fat cells have many of the same properties as cells harvested from bone marrow and actually have more mesenchymal stem cells (in other words, the little guys that turn into what is needed). In the case of MS, ideally the stem cells would work to regulate our immune systems, as well as repair some of the damage that has occurred.......full Multiple Sclerosis Blog in About.com: Multiple Sclerosis

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Acorda Multiple sclerosis Drug Wins Priority FDA Review

Washington (SmartAboutHealth) - Shares in drug maker Acorda have jumped after news broke that the FDA had granted priority review status to their experimental MS drug called Fampridine-SR.

This is great news for the company as back in March the FDA had refused to accept the filing application for the drug due to various “formatting” issues which Acorda have since took care of.

The FDA granted priority status to the drug because of its positive results in clinical trials.

A priority review, means that the agency will review the drug for possible approval much sooner than they would normally, thus Acorda will know of their decision by as early as October 22nd.....story in SmartAboutHealth.net

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What's new for 'Multiple Sclerosis' in PubMed

[A case-control study of the influence of the smoling behaviour in multiple sclerosis.] - Being a smoker/ex-smoker implies a 27% greater risk of developing MS compared to those who have never smoked. This risk is statistically significant for women but not for men due to the low number of them in the sample. - Meurologia. 2009 Apr;24(3):177-80. in PubMed

Cerebrospinal fluid and serum prealbumin (transthyretin) in patients with multiple sclerosis (MS): comparison of particular subgroups of MS patients. - Folia Microbiol (Praha). 2009;54(2):173-6. Epub 2009 May 6. in PubMed

Isolated abducens nerve palsy following mandibular block articaine anesthesia, a first manifestation of multiple sclerosis: a case report. - This case indicates that dental clinicians and neurologists may be alerted to isolated abducens palsy as a possible adverse effect of mandibular block articaine anesthesia. - Quintessence Int. 2009 Mar;40(3):251-6. in PubMed

Preactive lesions in multiple sclerosis. - Preactive lesions in MS represent early stages in the formation of destructive MS lesions. As many of them spontaneously resolve, they are expected to hold important clues to stop the inflammatory process in MS. - Curr Opin Neurol. 2009 Jun;22(3):207-13. in PubMed

Live imaging of remyelination after antibody-mediated demyelination in an ex-vivo model for immune mediated CNS damage. - Exp Neurol. 2009 Jan 13. [Epub ahead of print] in PubMed

A pilot study evaluating the safety and efficacy of modafinal for cancer-related fatigue. - In this pilot study modafinil was well-tolerated and effective for fatigue in patients with cancer. Improvements were also seen in mood, quality of life, and functional status. - J Palliat Med. 2009 May;12(5):433-9. in PubMed

[The Relevance of the TNF-alpha System in Psychiatric Disorders.] - During psychopharmacological treatment of schizophrenia, some antipsychotics might act on neurotransmitter metabolism via inducing the proinflammatory cytokine system. Hopefully, these hypotheses may lead to new therapeutical strategies for psychiatric patients in the near future. - Fortschr Neurol Psychiatr. 2009 May 4. [Epub ahead of print] in PubMed

Cutting edge: Natalizumab blocks adhesion but not initial contact of human T cells to the blood-brain barrier in vivo in an animal model of multiple sclerosis. - Our data demonstrate that alpha(4) integrin-mediated adhesion of human T cells to the inflamed BBB during EAE is efficiently blocked by natalizumab and thus provide the first direct in vivo proof of concept of this therapy in multiple sclerosis. - J Immunol. 2009 May 15;182(10):5909-13. in PubMed

Plasticity in MS: from Functional Imaging to Rehabilitation. - One potential practical application of the findings made on these neuroplastic processes is likely to be the development of specific rehabilitation methods, which can be used to enhance these reactive mechanisms in order to maintain MS patients functional abilities, and other specifically targeted approaches will also predictably be developed. - Int MS J. 2009 Apr;16(1):26-31. - in PubMed

The Diagnosis of MS. - Diagnosing multiple sclerosis (MS) is not always straightforward. The very nature of this disease means that it can manifest in multiple varied clinical presentations. Diagnosis is further confounded by the lack of a single diagnostic test and a gargantuan list of differential diagnoses. Traditionally the diagnosis of MS is a clinical one: with the history and/or examination revealing the separation in time and space of neurological episodes. In some cases, however, a diagnosis of "possible MS" might have to be made, for example, when the patient presents after a single event. Paraclinical investigations and diagnostic criteria may be of help in these situations. It is recommended that any diagnostic uncertainty is discussed openly with patients. - Int MS J. 2009 Apr;16(1):19-25. in PubMed

Physical Exercise and MS Recommendations. - The purpose of this review is, based on the existing research, to provide clinicians with some easily administrable recommendations for the application of exercise in the rehabilitation strategy of MS. - Int MS J. 2009 Apr;16(1):5-11. in PubMed

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Tuesday, May 5

Glutamate Identified As Predictor Of Disease Progression In Multiple Sclerosis

ScienceDaily (Apr. 29, 2009) — UCSF researchers have identified a correlation between higher levels of glutamate, which occurs naturally in the brain as a byproduct of metabolism, and greater disease burden in multiple sclerosis patients. The study is the first to measure glutamate toxicity in the brain over time and suggests an improved method for tracking the disease and predicting its course.

The research team employed a novel technique, developed by Radhika Srinivasan, PhD, study author and assistant researcher in the UCSF Department of Radiology and Biomedical Imaging, to measure glutamate levels in clinical trial patients. The technique was based on a sophisticated form of imaging known as proton MR spectroscopy, which uses simple radio-frequency pulses targeting specific brain chemicals.

Study findings were presented April 29, 2009 during the American Academy of Neurology annual scientific meeting in Seattle.............full report in Science Daily

The study was funded in part by the National MS Society.

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AAN 2009: Incidence of PML with Natalizumab in MS Lower Than Previously Thought

May 5, 2009 (Seattle, Washington) — The risk of developing progressive multifocal leukoencephalopathy (PML), a viral brain infection, in patients with multiple sclerosis (MS) taking the drug natalizumab (Tysabri, Biogen Idec) appears to be much lower — and the infection less deadly — than previously estimates, according to new postmarketing surveillance data.

Previous research found that the risk of developing PML was 1 in 1000, but new data show that the risk is closer to 1.2 per 10,000 patients, according to Carmen Bozic, MD, vice president and global head of drug safety and risk management for the maker of natalizumab, Biogen Idec, in Cambridge, Massachusetts.

Dr. Bozic delivered an updated overview of the risks and benefits of natalizumab here during the American Academy of Neurology (AAN) 61st Annual Meeting..........report in MedScape Today

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First Ten-Year Follow-Up Shows That Treatment With AVONEX Leads To Long-Term Benefits In Early Multiple Sclerosis Patients

Biogen Idec (NASDAQ: BIIB) announced data results from the CHAMPIONS ( C ontrolled H igh-Risk A VONEX ® (interferon beta-1a) M ultiple Sclerosis (MS) P revention Study I n O ngoing N eurologic S urveillance) study, an open label follow-up to CHAMPS ( C ontrolled H igh Risk Subjects A VONEX M S P revention S tudy). Based on the CHAMPS study, AVONEX was granted approval for use in patients who experienced their first clinical MS episode with MRI findings. The CHAMPIONS ten-year follow up showed that patients treated immediately after their first episode had significantly less chance of experiencing a second attack versus those patients with delayed treatment. These results at ten years also indicate that 80 percent of patients taking AVONEX were below an expanded disability status scale (EDSS) score of three. These data were presented as a poster at the Annual American Academy of Neurology (AAN) meeting. ...report in Medical News Today

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Setbacks In Patients With Relapsing-Remitting Multiple Sclerosis Can Be Reduced If Methylprednisolone Is Added To Interferon Beta

Conclusions reported in an Article published Online first, as well as in the June edition of The Lancet Neurology, and the announcement made at the American Academy of Neurology meeting in Seattle, USA, all coincide that the substantial decline of the deterioration rate in patients with relapsing-remitting multiple sclerosis (RRMS) can be accomplished by adding oral methylprednisolone (MP) to the standard treatment of subcutaneous interferon beta-1a (IFB1a). .....read the report in Medical News Today

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Study Highlights Economic Impact Of Early Mobility Impairment In People With Multiple Sclerosis

People with multiple sclerosis (MS) experience reduced income and earning potential as their mobility impairment increases, according to data collected from more than 8,100 participants of the North American Research Committee on Multiple Sclerosis (NARCOMS) database, the largest self-reported MS patient registry in the world. The data were presented at the American Academy of Neurology (AAN) 61st Annual Meeting in Seattle, WA. .....read the report in Medical News Today

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AAN: Higher-Than-Expected Leukemia Rates Seen with Mitoxantrone in MS

SEATTLE, May 5 -- Italian multiple sclerosis patients treated with mitoxantrone (Novantrone) developed leukemia at up to 10 times the rate seen in previous studies, researchers reported here.

In a retrospective study of patients treated in 35 Italian hospitals, leukemia developed in 7.4 multiple sclerosis patients per 1,000 treated, according to Vittorio Martinelli, M.D., of University Vita-Salute in Milan, Italy.

Earlier studies of the drug in multiple sclerosis patients had reported leukemia rates of 0.7 to 2.5 per 1,000 patients, Dr. Martinelli said.

But he noted that simply avoiding mitoxantrone is not necessarily a simple way to dodge leukemia risk, as the drug is frequently a last-resort treatment for MS patients.

Still, this and other side effects of mitoxantrone "should be carefully considered against the potential benefit," he said at a press briefing to announce the results.......full report in MedPage Today

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Saturday, May 2

AAN: Stormy Weather Worsens Sleep Apnea

SEATTLE, May 1 -- Patients with sleep-disordered breathing may find their condition worsens when a storm blows through town, researchers said here.

Obstructive apnea worsened as atmospheric pressure dropped due to weather-related changes, Michael J. Doherty, M.D., of Swedish Hospital here, and colleagues reported at the American Academy of Neurology meeting.

"We saw strong results between weather-related atmospheric pressure changes and sleep-disordered breathing," Dr. Doherty said.

Previous research has found that altitude is linked to worsening apnea, possibly a result of hypoxia or changes in air viscosity.

Altitude changes, however, correspond to central apnea, more so than obstructive apnea, which was most affected in the present study.

"We're not sure why that is," Dr. Doherty said. ......full report in MedPage Today

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AAN: Oral MS Drug with Novel Mechanism Beats Interferon-Beta1a

SEATTLE, May 1 -- An investigational drug for relapsing-remitting multiple sclerosis showed better efficacy than interferon-beta1a (Avonex) in a head-to-head trial, it was reported here.

Patients taking 0.5 mg/day of fingolimod, an oral agent also known as FTY720, in a randomized one-year trial had half the annualized relapse rate of those taking interferon-beta1a, said Jeffrey Cohen, M.D., of the Cleveland Clinic.

Speaking to a packed ballroom at the American Academy of Neurology's annual meeting, Dr. Cohen reported that the annualized relapse rate with fingolimod was 0.16 per year, compared with 0.33 (P<0.001) for interferon-beta1a at 30 mcg/week.

Moreover, 83% of patients taking 0.5 mg of fingolimod remained relapse-free during treatment, versus 69% of the interferon patients (P<0.0001).

"The study met its primary endpoint and demonstrated superiority of fingolimod over interferon-beta1a," Dr. Cohen said.

A higher dose of fingolimod, 1.25 mg/day, was also tested in the 1,292-patient study. Its efficacy was no better than the lower dose -- somewhat less impressive, in fact, by some measures, including annualized relapse rate -- and was associated with more adverse events, Dr. Cohen reported.

Fingolimod, a sphingosine-1-phosphate receptor modulator, had been tested earlier in placebo-controlled phase III studies. (See AAN: Promising Long-Term Results for Oral MS Drug) .......full report in MedPage Today

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AAN: Rituximab Shows Some Benefit in Primary Progressive MS

SEATTLE, May 1 -- Younger patients with primary progressive multiple sclerosis and those with gadolinium enhancing T1 lesions responded to rituximab (Rituxan) in a large placebo-controlled trial, it was reported here.

However, the OLYMPUS study failed to meet its primary endpoint, confirmed disease progression within 96 weeks for rituximab versus placebo among all patients, said Kathleen Hawker, M.D., of Ohio State University in Columbus, Ohio.

"It was a disappointment," said Dr. Hawker after her formal presentation here at the American Academy of Neurology's annual meeting.

But she emphasized that the improvements seen in the younger patients and those with T1 lesions visible on gadolinium-enhanced MRI scans meant that rituximab may still benefit substantial numbers of patients.

Dr. Hawker also noted that there is currently no approved therapy for primary progressive MS.

Rituximab selectively depletes CD20-positive B cells. Research in the past few years has indicated that these cells play a key role in the major forms of MS, as well as many other autoimmune diseases.

The trial assigned 439 patients in a 2:1 ratio to either rituximab or placebo, given in four courses 24 weeks apart. Each course consisted of two infusions given two weeks apart. The rituximab dose was 1 g per infusion.

Patients' mean age was 50 with a median disease duration from symptom onset of nine years, and four years from diagnosis. About 25% had gadolinium-enhancing lesions at baseline.

The primary outcome measure, onset of confirmed disease progression by week 96, was seen in 38.5% of the placebo group and 30.2% of those taking the drug (P=0.144), Dr. Hawker reported.

She said the expectation going into the study -- based in part on a similar study in relapsing-remitting multiple sclerosis, which did find a significant benefit for rituximab -- was that disease progression would be seen in about 30% of the placebo group and 16% of those taking rituximab.(See Rituximab Effective Against MS in Phase II Trial)

But in patients younger than 51, the hazard ratio for disease progression with the drug versus placebo was 0.52 (P=0.010).

And for patients with gadolinium-enhancing T1 lesions at baseline, the hazard ratio for progression was 0.41 (P=0.007), Dr. Hawker reported.

She said these two groups together accounted for roughly half of patients in the trial after accounting for overlap.

T2 lesion volume was also significantly lower at week 96 in the rituximab group, although brain volume did not differ.

Disease duration did not predict treatment response, Dr. Hawker noted.

Serious infections, mainly in the urinary and respiratory tracts, were more common with rituximab, seen in 4.5% of patients compared with 1% of the placebo group.

Infusion-related events were also more frequent with rituximab. Nearly half of all such events occurred with the first infusion and they declined steadily thereafter.

Other events, serious and nonserious, were similar between treatments. Overall, the adverse effect profile was similar to that seen with rituximab in relapsing-remitting MS, Dr. Hawker said.
Scott Zamvil, M.D., of the University of California San Francisco, said the study was among the half-dozen most important clinical trials in multiple sclerosis reported at the meeting.

That rituximab didn't meet its primary efficacy endpoint "doesn't mean it's not an effective drug in this case," said Dr. Zamvil, who was not involved with the study.

"It's clear there was significantly less increase in T2 lesion volume," he noted, as well as the favorable outcomes for younger patients and those with gadolinium-enhancing T1 lesions. .....story in MedPage Today

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MRI Data Showing Tysabri® Promoted Remyelination Presented At The 61st Annual Meeting Of The American Academy Of Neurology

Biogen Idec (NASDAQ: BIIB) and Elan Corporation, plc (NYSE: ELN) announced results of a study demonstrating that TYSABRI® (natalizumab) promoted regeneration and stabilization of damage done to the myelin sheath, as measured by advanced MRI technology. Damage to the myelin sheath causes the symptoms of multiple sclerosis (MS). Additional posters will also be presented during the Congress highlighting the ability of TYSABRI, in some patients, to improve physical function and patient reported outcomes on cognition, quality of life, and fatigue. TYSABRI is the first approved MS therapy with reported data suggesting that some of the signs of disease progression can be stopped. The strong efficacy profile demonstrated in clinical trials is enhanced further from these data and may help redefine success in MS."

What we have seen in these MRI data suggest that TYSABRI may have the capacity to repair and possibly restore some of the damaged myelin sheath that protects nerve fibers. Results from this study support the continued investigation of the potential effects of TYSABRI on this process," said Robert Zivadinov, M.D., of the Jacobs Neurological Institute in Buffalo, N.Y., the lead .....full report in Medical News Today

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First Ten-Year Follow-Up Shows That Treatment With AVONEX® Leads To Long-Term Benefits In Early Multiple Sclerosis Patients

Biogen Idec (NASDAQ: BIIB) announced data results from the CHAMPIONS (Controlled High-Risk AVONEX (interferon beta-1a) Multiple Sclerosis (MS) Prevention Study In Ongoing Neurologic Surveillance) study, an open label follow-up to CHAMPS (Controlled High Risk Subjects AVONEX MS Prevention Study). Based on the CHAMPS study, AVONEX was granted approval for use in patients who experienced their first clinical MS episode with MRI findings. The CHAMPIONS ten-year follow up showed that patients treated immediately after their first episode had significantly less chance of experiencing a second attack versus those patients with delayed treatment. These results at ten years also indicate that 80 percent of patients taking AVONEX were below an expanded disability status scale (EDSS) score of three. These data were presented as a poster at the Annual American Academy of Neurology (AAN) meeting. ....full report in Medical News Today

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Adding Steroid Drug To MS Treatment May Reduce Disease Activity

Using a steroid drug for multiple sclerosis (MS) in addition to an MS drug may reduce the amount of disease activity more than using the MS drug alone, according to a study that will be presented as part of the Late-breaking Science Program at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 - May 2, 2009.

For the study, people with MS received the steroid drug methylprednisolone in monthly "pulses," or three doses over three days, in addition to regular weekly treatment with the drug interferon beta-1a. The steroid drug has typically been used only to treat acute MS attacks, not as an ongoing treatment.

The study involved 341 people with relapsing-remitting MS. Half of the participants received both drugs; half received only the interferon drug plus a placebo. The participants were seen every three months during the three-year study for evaluation.

The participants had the disease for an average of three years and had not yet received a disease-modifying drug such as interferon.

Those who received both drugs had 38 percent fewer relapses, or times when the disease is active, than those receiving only the interferon drug. They also improved slightly on a test of MS disability, while the scores for the placebo group decreased slightly.

At the beginning of the study and again after three years, the researchers measured the size of lesions in the brain that are a sign of disease activity. For those receiving both drugs, the lesions stayed the same size or shrunk, while the size of the lesions grew for those taking only interferon."

These results indicate that these two drugs may have a synergy when taken together and provide a more beneficial effect on the disease activity," said study author Mads Ravnborg, MD, of the Danish Multiple Sclerosis Research Center at Copenhagen University Hospital in Denmark. "This is a promising finding, as the benefit from interferon is only moderate and not everyone responds fully to the treatment, so anything we can do to boost those results is positive."

The study was supported by Biogen Idec.......full report in Medical News Today

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Risk Of Leukemia With Multiple Sclerosis Drug Higher Than Thought

The risk of developing leukemia as a side effect of a drug for multiple sclerosis (MS) is higher than previously reported, according to a study to be presented as part of the Late-breaking Science Program at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 - May 2, 2009.

Mitoxantrone is an immunosuppressant drug approved by the FDA for treatment of several forms of advancing MS. It is one of only two drugs that has been shown to benefit people with secondary progressive MS who are having attacks. However, the drug can cause heart damage at high total doses. Due to this, the lifetime cumulative dose is equal to about eight to 12 doses over two to three years.......full report in Medical News Today

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Multiple Sclerosis in "Medical News Today"

Two-Year Phase III Data Presented At AAN 61st Annual Meeting Show Positive Outcome Of Cladribine Tablets In Patients With Multiple Sclerosis - Merck KGaA announced detailed results of the two-year (96-week) placebo-controlled CLARITY (1) Phase III trial using Cladribine Tablets (Merck's proprietary investigational oral formulation of cladribine) to treat patients with relapsing-remitting multiple sclerosis (MS). The results of the pivotal trial show that annual short-course treatment with Cladribine Tablets led to a significant reduction in the rate of clinical relapses, disability progression and brain lesions, as well as a significant increase in the proportion of patients who remained relapse-free. The data were presented today for the first time, as a late-breaking oral presentation at the 61st Annual Meeting of the American Academy of Neurology (AAN) in Seattle...........full report in Medical News Today

New Data Presented At American Academy Of Neurology Congress Show 80-83% Of MS Patients On Oral FTY720 Were Relapse-free For One Year - New Phase III results presented at the American Academy of Neurology (AAN) congress show that 80-83% of patients taking FTY720 (fingolimod), an investigational oral compound for relapsing-remitting multiple sclerosis, remained free of relapses during the one-year study compared to 69% of those on interferon beta-1a[2], an established standard of care[3] (p<0.001).......full report in Medical News Today

New Data Illustrate Novel Mechanism of Action of Laquinimod, An Oral Compound For The Treatment of Multiple Sclerosis - Teva Pharmaceutical Industries Ltd. (NASDAQ: TEVA) and Active Biotech (NASDAQ OMX NORDIC: ACTI) announced results from several new clinical and preclinical studies providing further insight on the immunomodulatory mechanism of action (MOA) of laquinimod, a novel oral once-daily compound being developed for the treatment of relapsing-remitting multiple sclerosis (RRMS). Four sets of data being presented at the 61st Annual Meeting of the American Academy of Neurology (AAN) in Seattle stand to increase the understanding of how laquinimod may reduce multiple sclerosis (MS) activity and affect mechanisms related to disease pathology.While research looking at the mechanism by which the compound exerts its clinical effect is ongoing, currently available data indicate that laquinimod impacts RRMS by modulating key processes of the immune system, and suggest an immunomodulating effect within the central nervous system (CNS). ....full report in Medical News Today

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What's new for 'Multiple Sclerosis' in PubMed

Alcohol misuse and multiple sclerosis. - Despite the numerous health and social consequences of alcohol misuse, routine screening and intervention for people with MS remain uncommon. Brief screening and advice to reduce or refrain from alcohol use can be accomplished in as little as 5 minutes and can be incorporated into the regular course of medical care. - Arch Phys Med Rehabil. 2009 May;90(5):842-8. in PubMed

The impact of multiple sclerosis on patients' performance on the Stroop Test: processing speed versus interference. - J Int Neuropsychol Soc. 2009 May;15(3):451-8. in PubMed

Examination of processing speed deficits in multiple sclerosis using functional magnetic resonance imaging. - Although it is known that processing speed deficits are one of the primary cognitive impairments in multiple sclerosis (MS), the underlying neural mechanisms responsible for impaired processing speed remain undetermined. - J Int Neuropsychol Soc. 2009 May;15(3):383-93. in PubMed

[A new therapeutic approach for autoimmune diseases by the sphingosine 1-phosphate receptor modulator, fingolimod (FTY720)] - Nihon Rinsho Meneki Gakkai Kaishi. 2009 Apr;32(2):92-101. in PubMed


Multiple sclerosis: hyperintense dentate nucleus on unenhanced T1-weighted MR images is associated with the secondary progressive subtype. - Hyperintensity of the dentate nucleus may be present on unenhanced T1-weighted MR images of patients with MS and is associated with the secondary progressive disease subtype and with increased clinical disability, lesion load, and brain atrophy. - Radiology. 2009 May;251(2):503-10. in PubMed

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