Tags
Blog

'research' posts

Hematopoietic Stem Cells for Multiple Sclerosis

The MS Center at Swedish Neuroscience Institute played a major role in a research study that recently garnered national attention. This research was published in JAMA Neurology. This research investigated the effect of high dose immunosuppressive followed by hematopoietic stem cell therapy.

This therapy consists of collecting hematopoietic stem cells from patients' blood. Patients then undergo an intense course of immunosuppressive therapy with four medications. This therapy is sufficient to eliminate most of the patient’s bone marrow including white blood cells. The hematopoietic stem cells are then given back to the patient so that their bone marrow may be reconstituted. In multiple sclerosis (MS),  the immune system attacks the brain. The hope is that with this therapy the reconstituted immune system will have less of a tendency to attack the brain and that the disease will stabilize.

This is our second study on this technique in MS. The first study investigated the effect of this treatment on patients with more advanced disease. All but  ...

Gilenya fails in primary progressive multiple sclerosis trial

We recently found out that Gilenya (fingolimod), an oral treatment for relapsing multiple sclerosis (MS), did not slow down disability progression in a phase III trial among primary progressive MS (PPMS) patients. The trial, called INFORMS, was the largest to date in PPMS, involving 970 patients in North America, Europe, and Australia. Patients were assigned to placebo or Gilenya for 3 years, and the primary outcome was a composite of walking, arm function and overall disability measures. Unfortunately, the progression rates in Gilenya and placebo groups were not statistically different. A full report of the trial will be presented at one of the upcoming neurology meetings, possibly in April 2015.

What type of MS do I have?

Traditionally, MS has been divided into four clinical courses: relapsing/remitting, primary progressive, secondary progressive and progressive relapsing. These four were intended as descriptions of the different courses that MS could take in patients, and were not based on any particular understanding of the biology of the disease, the cause of the disease, or even the prognosis of patients with the different types of MS. Over the years, our understanding of MS has improved, and these descriptions of the disease course no longer meet our needs to describe the disease.

Over the past couple of years, there has been a revision of our classification of MS, resulting in a publication in July 2014. The recommendations of this revision have been  ..

No “window of opportunity” for celiac disease prevention

As a pediatric gastroenterologist, I’m often asked whether there is any way to prevent a child from developing celiac disease. Based on what I knew regarding how food allergies develop, I used to counsel families that there might be a “window of opportunity”, between four and six months, when it’s possible to introduce grains and other gluten-containing foods that could potentially “teach” the immune system to tolerate gluten and thus lower the risk of developing celiac disease.

However, my “window theory” recently got thrown out the window when the results of two important scientific studies were published in the New England Journal of Medicine.

Lemtrada is FDA approved for people with relapsing MS

On November 14, 2014, the U.S. Food and Drug Administration (FDA) approved Lemtrada (alemtuzumab) for the treatment of patients with relapsing forms of multiple sclerosis (MS) who have responded inadequately to two or more MS drugs.  Lemtrada is already approved in over 40 countries around the globe including the EU, Canada and Australia.

The FDA approval of Lemtrada is a significant milestone for people living with relapsing MS.  Lemtrada demonstrated superior efficacy over Rebif on annualized relapse rates in two pivotal randomized Phase III open-label rater-blinded studies in patients with relapsing remitting MS which were the basis for approval.  The clinical development program for Lemtrada involved nearly 1,500 patients including patients at the Swedish MS Center with more than ...

Breastfeeding, Disease Modifying Therapies (DMTs), and Postpartum Relapse in Multiple Sclerosis

Women with multiple sclerosis (MS) have higher risk of relapse during the postpartum period.  Can exclusive breastfeeding alone prevent relapses? How soon after delivery should disease modifying therapies (DMTs) be reintroduced? Are any DMTs safe to take while breastfeeding? 
 
While disease modifying therapies (DMTs) have been shown generally to reduce relapse rates, none of them are indicated for use during pregnancy and lactation. Therefore, the question of when to restart DMTs postpartum remains a difficult one for physicians counseling MS patients who wish to breastfeed their children.
 
Trying to predict the risk of relapse for any one individual is very difficult. The risk factors for postpartum attacks include ...

A (Slightly) New Medication for Multiple Sclerosis Comes Out in November

Interferons have been used for the treatment of multiple sclerosis (MS) since 1993. The existing line-up of interferons for MS (Avonex, Betaseron, Extavia and Rebif) will soon be joined by Plegridy, approved by the US Food and Drug Administration in August 2014. Plegridy will become commercially available in November 2014.

Plegridy is a pegylated form of interferon beta. Pegylation is a process, used by several other non-MS medications, whereby a long string of polyethylene glycol molecules is attached to the interferon beta molecule, to extend its half-life by reducing clearance via kidneys or other elimination pathways in the body. This modification allows less frequent dosing of Plegridy – once every two weeks – although it is still administered as an injection under the skin.

In the ADVANCE trial, Plegridy was ..
Results 1-7 of 64