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#Post#: 180--------------------------------------------------
MSAA MS research updates
DIR By: agate
Date: February 19, 2014, 3:09 pm
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The MSAA has a research update covering the recent
ACTRIMS/ECTRIMS conference in Boston:
--- Quote ---
> Highlights from the 2014 Joint ACTRIMS-ECTRIMS Meeting
>
>
> Written by Margaret M. McCormick, RN, BSN, MSCN
> Reviewed by Jack Burks, MD, MSAA Chief Medical Officer
> Edited by Susan Wells Courtney
>
> Every three years, two international organizations come
together to share, discuss, and debate the most recent basic and
clinical research findings in the area of multiple sclerosis
(MS). The joint meeting, alternately hosted in North America and
Europe, took place in Boston, Massachusetts September 10th
through 13th.
>
> This is the sixth triennial joint conference of ACTRIMS
(Americas Committee for Treatment and Research in Multiple
Sclerosis) and ECTRIMS (European Committee for Treatment and
Research in Multiple Sclerosis). ECTRIMS, established in 1984,
is the European professional organization dedicated to
understanding the cause and pathophysiology of MS and to the
development of new treatments. ACTRIMS, established in 1995, is
the North American counterpart to ECTRIMS, and provides a forum
to exchange information, debate current issues, and discuss
advances related to basic and clinical issues in research in MS
and other demyelinating diseases.
>
> This summary of the ACTRIMS-ECTRIMS Sixth Triennial Joint
Meeting highlights focuses on topics of particular interest to
those directly affected by MS and MS healthcare professionals.
While we would like to include more information, only a fraction
of the more than 1,700 scientific papers and almost 200
presentations could be addressed in this article.
>
> Experimental Therapies
>
> Lemtrada® (alemtuzumab, formerly Campath), is given
intravenously each day for five days and again one year later,
daily for three days. Lemtrada has been submitted to the United
States Food and Drug Administration (FDA) for approval; a
decision is expected in late 2014.
>
> The majority of patients treated with Lemtrada (alemtuzumab)
in the CARE-MS I study (a Phase III comparison of alemtuzumab
and Rebif in treatment-naïve patients) were free of new brain
lesions and magnetic resonance imaging (MRI) activity at year
three. Although the majority of the patients did not receive
treatment after the first two yearly courses of Lemtrada, most
continued to experience a slowed yearly rate of brain volume
loss over three years.
>
> ...
>
> Laquinimod is an oral medication taken once daily under
investigation for the treatment of RRMS. In the Phase III BRAVO
trial, treatment with laquinimod resulted in a significant
reduction in brain atrophy (reduction) in both grey matter and
white matter, compared to placebo. Using pooled data from the
ALLEGRO and BRAVO trials, researchers determined that laquinimod
demonstrated significant benefits in relapse, disability,
walking, and MRI outcomes in patients with RRMS with Expanded
Disability Status Scores (EDSS) of more than 3 (where an
individual is able to walk but experiences moderate difficulty
in one functional system [FS] or mild difficulty in another
area).
>
> ...
>
> Daclizumab (also known as Zenapax®) is given by intravenous
(IV) infusion every four weeks and is also studied when given in
subcutaneous injections. It is under investigation for the
treatment of both RRMS and secondary-progressive MS (SPMS).
Primary results were reported for the DECIDE study in which
1,841 RRMS patients were randomized to treatment with either
Avonex (interferon beta-1a) 30 mcg every week or daclizumab HYP
(high-yield process) 150 mg every four weeks, both delivered by
subcutaneous injection (under the skin).
>
> Treatment with daclizumab resulted in a 45-percent reduction
in annualized relapse rate (ARR), a 54-percent reduction in new
and newly enlarging T2 lesions, and a 65-percent reduction in
new gadolinium-enhancing lesions. Risks associated with
daclizumab treatment included infections, rash dermatitis, and
liver enzyme abnormalities.
>
> ...
>
> Generic Disease-Modifying Therapies
>
> A nine-month randomized, double-blind trial of 794 people with
RRMS, called “GATE,” demonstrated that generic glatiramer
acetate was equivalent to Copaxone® and superior to placebo in
both safety and efficacy. The concept of generic versions of MS
disease-modifying therapies is relatively new to the MS
community, as the original drugs were protected by law to have a
certain period of exclusivity. As these time periods expire,
other pharmaceutical companies may look to provide similar
drugs. MSAA published an online article on this topic titled,
“The Issues Surrounding Generic Versions of MS Drugs.”
>
> Pregnancy and Breastfeeding
>
> Pregnancy:
>
> Because DMTs are not tested in pregnant women, information
about the potential risks of fetal exposure is not available to
guide decision-making by women who are pregnant or wish to
become pregnant. Gathering as much information as possible on
this important question is critical to women with MS during
child-bearing years. Although women are advised to use birth
control and to discontinue DMTs when they wish to become
pregnant, fetuses are exposed during unexpected pregnancies or
with the intentional use of DMTs during pregnancy. The outcomes
of these pregnancies are monitored during clinical trials and
through pregnancy registries following product approval.
>
> While the data presented at the meeting on pregnancy were
encouraging, as a limited number of women who became pregnant on
DMTs did not see abnormalities in their babies, individuals with
MS need to be strongly cautioned. These data were on small
numbers of women and do not suggest that getting pregnant is
considered safe while taking DMTs. The recommendations of the
FDA and MS experts still stand for women on DMTs to take
preventative measures to avoid pregnancy.
>
> Breastfeeding:
>
> In a German study of 201 women, women with MS who breastfed
their newborn infants for two months exclusively did not
experience more post-partum relapses than those who bottle-fed
or used supplemental feedings.
>
> A 10-year study of all pregnancies in a hospital in Spain
found no difference in the course of MS disease between women
who chose to breastfeed and women who chose artificial feeding
and restarted their treatment sooner.
>
> Risk Factors and MS
>
> MS is a disease marked by feelings of loss of control due to
the unpredictable nature of the disease. While still
unpredictable, it is encouraging to discover that there are
lifestyle factors under one’s control that have the potential to
modify the course of the disease. Research is ongoing around
what are known as modifiable risk factors, which include
smoking, exercise, body weight, salt intake, and Vitamin D
levels.
>
> Smoking
>
> The risk of developing anti-natalizumab antibodies (which
decrease the effectiveness of Tysabri) was 2.4 to 2.7-times
higher in smokers than in non-smokers, with a trend toward
increasing risk with increasing intensity of smoking.
>
> People with MS with the HLA-DRB1*15:01 gene who smoked had a
higher annualized relapse rate (ARR) during treatment with
interferon-beta than those who did not smoke.
>
> Thirty-two genes are expressed differently in MS patients who
smoke and those who do not smoke. Smoking was found to increase
the genes involved in the pro-inflammatory process in people
with MS.
>
> Salt
>
> In a study of 70 RRMS patients over a period of one year,
higher salt intake was associated with a 2.75 to 3.95-times
higher relapse rate as compared with those in the low-intake
group. Higher salt intake was also associated with a 3.4-fold
higher chance of developing a new MRI lesion. Similar findings
were documented in a subsequent study of 52 patients.
>
> Obesity
>
> A relationship was found between the interaction of infectious
mononucleosis (IM) and adolescent obesity and the risk of
developing MS. A possible explanation, according to the study
authors, is that an obese state both impacts the cellular immune
response to infections such as IM and causes a state of chronic
immune-mediated inflammation. Women with a higher weight in
adolescence and higher body mass index (BMI) in early adulthood
were younger at the time of their diagnosis with MS.
>
> Vitamin D
>
> Vitamin D levels were lower in those with progressive MS than
RRMS in a retrospective study of 181 people with MS. (A
retrospective study is one that reviews data previously
collected for another reason.) A relationship was also found
between Vitamin D levels and the degree of disability in a
subgroup of people with RRMS.
>
> As Vitamin D levels decreased, the number of new, active
lesions increased in a study population of individuals with RRMS
from the BEYOND study (a study that compared treatment of two
different doses of Betaseron with Copaxone). This relationship
was present even in the population that was considered to have
adequate levels of Vitamin D.
>
> Vitamin D level was only associated with the risk of relapse
in those patients carrying at least one copy of HLA-DRB1 or
HLA-DRB3, the strongest genetic risk factor for MS in a group of
children diagnosed with MS or with clinically isolated syndrome
(CIS). This latter syndrome refers to individuals who show
certain symptoms of MS, but do not have enough evidence of the
disease to confirm a diagnosis of MS.
>
> Other Topics
>
> OCT
>
> Optical coherence tomography (OCT), a non-invasive imaging
test that uses light waves to take cross-section pictures of the
retina, might help determine brain atrophy (reduction) without
the need for a brain MRI. Researchers found that certain changes
in the retina accurately reflected grey matter atrophy in the
whole brain, especially in those with progressive MS.
>
> Parasitic Infections and MS
>
> Parasite infection was found to be protective against MS
disease activity in a group of 12 parasite-infected MS patients.
Compared to individuals with MS who were not infected,
parasite-infected MS patients experienced a significantly lower
number of relapses, a lower change in EDSS scores, and fewer
brain lesions on MRI. Conversely, when treated with
anti-parasitic drugs, the parasite-infected group experienced
worsening of their disease.
>
> Adherence to MS Medications
>
> In a group of German people with MS who completed an anonymous
online survey of medication-adherence behavior, 35 percent
reported problems with adherence. Patients who had realistic
expectations of the benefits of adherence, good self-management
skills, and reliable sources of information, were more adherent.
An individualized program of patient counseling (PCP) resulted
in increased adherence related to better management of adverse
events.
>
> Gut Microbial Environment
>
> Studies have related gut dysbiosis (an imbalance in the
microorganisms in the gut resulting from too few good bacteria
and/or too many harmful bacteria) with development or severity
of many conditions, including Crohn’s disease, type I diabetes,
obesity, and autism. The Corinne Goldsmith Dickinson Center for
Multiple Sclerosis at Mount Sinai Hospital in New York City and
University of California San Francisco MS Center are
collaborating to study whether gut dysbiosis may have an impact
on MS.
>
> Iron Deposits
>
> Neurodegeneration (injury to nerves) is associated with the
accumulation of iron in the oligodendrocytes (cells that produce
and repair myelin), and appears to contribute to disability in
MS. Researchers studied the brains of individuals who died from
complications associated with MS and found that iron was
primarily stored in the oligodendrocytes.
>
> Remyelination
>
> Signs of remyelination (myelin repair) may be present even in
cases of profound axonal (nerve) damage. Examination of biopsied
brain tissue from patients with early MS (obtained to exclude
diseases such as infection or cancer) revealed that signs of
remyelination are sometimes present, despite the fact that these
lesions were mainly demyelinated (where myelin is no longer
present).
>
> Although remyelination occurs in MS, it is often not
sufficient to prevent irreversible damage and progressive
disability. Researchers are beginning to understand the steps in
the remyelination process. Oligodendrocyte progenitor cells
(OPC) have been identified as one of the main cell types
responsible for remyelination. These cells can now be identified
through the use of certain markers, allowing the process to be
studied in-depth.
>
> MS Treatment with Myelin Peptide Skin Patches
>
> MS treatments that could more specifically inhibit the
inflammatory activity of the immune system could potentially
represent an improvement over current medications that have a
more global effect. To that end, researchers tested a myelin
peptide infused skin patch in two different doses compared to a
placebo, to determine whether it could help stop the
inflammatory response that can result in damage to the brain.
>
> The patches strongly suppressed the inflammatory response and
also resulted in a positive clinical effect. Compared to the
placebo group, patients in the treated group had positive
responses with respect to the number of brain lesions, annual
relapse rate (ARR), number of individuals who were relapse-free,
disability, and EDSS scores. There were no serious adverse
events. Redness and itching in the local area of the patch was
observed in 20 percent of the individuals in the treatment
group.
>
> Stem Cells
>
> Results of a Phase I safety study of stem cell transplantation
were reported. Twenty-four individuals with RRMS or SPMS who had
EDSS scores of 3.0 to 6.5 received a single IV infusion of
mesenchymal stem cells that were derived from their own bone
marrow.
>
> No significant safety issues resulted; no serious or severe
adverse events occurred; and there were minimal infusion-related
side effects. The trial was not designed to test efficacy and
there was no evidence of either disease activation or
improvement with respect to brain lesions or any other measures
tested. The safety study was successful, but before Phase II
trials are considered, many questions need to be addressed.
These include issues of cell dose, route of administration,
number of infusions, and whether cells are derived from the
patient or a disease-free donor.
>
>
--- End Quote ---
The article can be seen here
HTML http://mymsaa.org/news-msaa/1178-actrims-ectrims-2014-highlights.
#Post#: 722--------------------------------------------------
Re: MSAA MS research update
DIR By: agate
Date: April 14, 2015, 2:10 pm
---------------------------------------------------------
The MSAA has issued a 2015 research update that looks as if it
might be very useful and comprehensive.
It can be seen here
HTML http://mymsaa.org/publications/msresearch-update-2015/.
#Post#: 1441--------------------------------------------------
Re: MSAA MS research updates
DIR By: agate
Date: November 3, 2016, 2:44 pm
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Here is the MSAA research update, highlighting some of the
research presented at the September 2016 ECTRIMS conference:
HTML http://mymsaa.org/news/ectrims-2016-summary/
HTML http://mymsaa.org/news/ectrims-2016-summary/
#Post#: 1703--------------------------------------------------
2017 MSAA MS research update
DIR By: agate
Date: May 26, 2017, 4:32 pm
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The MSAA 2017 MS research update:
HTML http://mymsaa.org/publications/msresearch-update-2017/#Experimental
HTML http://mymsaa.org/publications/msresearch-update-2017/#Experimental
#Post#: 1947--------------------------------------------------
MSAA video, "Review of the most promising MS research
happening now"
DIR By: agate
Date: January 6, 2018, 7:56 pm
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The MSAA, in conjunction with a couple of pharmaceutical
companies, has presented this video, "A Review of the Most
Promising MS Research Happening Now":
HTML https://education.webmd.com/viewarticle/833759#content=0_0
#Post#: 2099--------------------------------------------------
MSAA 2018 research update
DIR By: agate
Date: May 29, 2018, 6:22 pm
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The MSAA 2018 MS research update provides information on the
various therapies currently in use or being considered:
HTML https://mymsaa.org/publications/msresearch-update-2018/
#Post#: 2142--------------------------------------------------
Research highlights from AAN and CMSC 2018 annual meetings
(MSAA)
DIR By: agate
Date: July 7, 2018, 5:35 pm
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Research Highlights from the AAN and CMSC 2018 Annual Meetings
(MSAA), July 6, 2018:
HTML https://mymsaa.org/news/2018-aan-cmsc-summary/
#Post#: 2290--------------------------------------------------
2018 ECTRIMS annual meeting--MSAA research update
DIR By: agate
Date: November 29, 2018, 1:48 pm
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2018 ECTRIMS annual meeting--MSAA research update:
HTML https://mymsaa.org/news/2018-ectrims-annual-meeting/?utm_source=ms_research&utm_medium=email
#Post#: 2534--------------------------------------------------
MSAA annual research update (2019)
DIR By: agate
Date: May 31, 2019, 11:22 am
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The MSAA annual research update for 2019:
HTML http://bit.ly/MSResearchUpdate
#Post#: 2583--------------------------------------------------
July 2019 MS Research Update (MSAA)
DIR By: agate
Date: July 15, 2019, 1:28 am
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A July 2019 MS research update from the MSAA:
HTML http://bit.ly/2xLdTcJ
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