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Swedish Multiple Sclerosis Blog Blog

'MS Center' Swedish Multiple Sclerosis Blog posts

Importance of planning pregnancies with Multiple Sclerosis (MS)

A recent study addressed the outcomes of pregnancy in women with MS who were taking fingolimod (Gilenya). Of 66 pregnancies on the medication, 41 attempted to carry the pregnancy to term. 26 of the 41 had healthy newborns. There were, 9 miscarriages, 24 elective abortion, 4 ongoing pregnancies and 1 with an unknown outcome. Of the elective abortions, four were for fetal malformations. There were 5 cases with abnormal fetal development in the 66 pregnancies. Poor fetal outcomes were found in 14.6% of the pregnancies. This contrasts with a 3% rate of poor outcomes for most pregnancies.

This paper highlights the importance of care in planning pregnancies in MS. It is now known that women with MS have ...

Functional Electrical Stimulation (FES) braces improve gait

Up to 80 percent of people with multiple sclerosis (MS) have problems with walking.  The combination of weakness of the muscles of the legs, spasticity, and core weakness contributes to this.  Often, it will present with problems lifting the foot, referred to as foot drop.  This is due to weakness of the muscles that lift the foot (dorsiflexors) and spasticity or over power of the muscles that push the foot down (plantar flexors).  Traditional ankle foot orthosis have advantages over functional electrical stimulation (FES) braces in that they help with ankle stability and reduce spasticity.  Advantages of FES braces include some evidence that there may be stimulation of the cortical neurons above the stimulation area, they are less cumbersome, and more discrete to wear.

A recent study looked at ..

FDA declines approval of Lemtrada for the treatment of MS

On December 30, 2013, the US Food and Drug Administration declined to approve the use of alemtuzumab (Lemtrada) for the treatment of multiple sclerosis. The FDA stated that the manufacturer of Lemtrada “has not submitted evidence from adequate and well-controlled studies that demonstrate the benefits of Lemtrada outweigh its serious adverse effects.” This was a surprising decision to some, as only a month earlier an advisory panel of experts convened by the FDA, while raising some objections, voted to have this medicine approved. The manufacturer of Lemtrada, Genzyme, a Sanofi company, intends to appeal this decision.
 
In response, a number of MS organizations and experts have voiced their concerns that with this step, MS patients are left without a potential choice in therapy. This decision is particularly difficult for ...

FDA approves 40 mg/mL Copaxone for 3 times a week

The U.S. Food and Drug Administration (FDA) has approved the three-times-a-week COPAXONE® 40mg/mL, a new dose of COPAXONE® on Jan 28, 2014.  This new formulation will allow for a less frequent dosing regimen administered by injection for patients with relapsing forms of multiple sclerosis (MS). In addition to the newly approved dose, daily COPAXONE® 20 mg/mL will continue to be available.

The FDA approval is based on data from ...

Weak link between epsilon toxin and MS

A recent article has been published suggesting that MS may be caused by a bacterial toxin. The bacteria is Clostridium Perfringens, a common bacteria found in soil and a cause of food poisoning. This bacteria can produce a number of toxins, one of which is the epsilon toxin.

This study found that about 10% of people with multiple sclerosis (MS) had antibodies to the epsilon toxin, compared to 1% of people without MS. In pathology specimens from mice, the epsilon toxin was found to bind to blood vessels in the retina of the eye, and to myelin in the brain. The authors also reported a single case of a woman with MS who was infected with Clostridium Perfringens and that was producing the epsilon toxin.

Though this study has been widely discussed online, I think that it is unlikely that this will be the answer to the MS problem. This study was primarily in pathology tissue, which found that the toxin was able to bind to myelin. Many more studies will be needed to determine whether this toxin is capable of causing damage to myelin of the type that is seen in MS. There are many other known toxins to myelin, but so far none seem to be the cause of MS.

They tried to show that ..

2013 World Atlas of MS published

The 2013 World Atlas of MS has been published by MS International Foundation and is available here. The key findings are:

  1. The estimated number of people with MS has increased from 2.1 million in 2008 to 2.3 million in 2013
  2. The 2:1 ratio of women to men with MS has not changed significantly since 2008
  3. Substantial global inequalities remain in terms of access to treatment and medical care

Research and progress for progressive Multiple Sclerosis (MS)

I am delighted to write the blog over the Progressive MS session that was given at ECTRIMS 2013.  Much emphasis has been given to the need for more research in the fields of progressive MS.  The majority of MS patients fit into this broad category: primary progressive MS, secondary progressive MS, and progressive relapsing forms of the disease.  During a session devoted to progressive MS, leaders in the field discussed several initiatives underway to address the challenges presented by these forms of the disease. 

Rehabilitation is a mainstay and key to improving the lives of patients with progressive MS. Many patients describe their progression in terms of mobility decline, which is a major target of improvement in rehabilitation programs.

The first session was devoted to confusion surrounding the definition of “progression in MS.”  We use ...

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