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Insufficient evidence to support complementary and alternative therapies for multiple sclerosis

A guideline was recently published about the use of complementary and alternative medicine in multiple sclerosis (MS).

The guideline process involves identifying all of the scientific articles about potential therapies and evaluating them based on their scientific merits. The evaluation process follows a strict set of requirements related to the conduct of the research.

The review included a wide variety of complementary and alternative therapies that have been proposed for MS. Not surprisingly, most therapies did not have sufficient scientific data to determine whether or not they were effective. Some cannabinoid preparations (marijuana extracts) were shown to be effective, primarily for spasticity. This reflects a relatively large number of studies done with these compounds and the availability of a commercially available extract in some countries. A handful of therapies were shown to be ineffective. Most therapies had insufficient studies to determine their effectiveness.

The importance of this review is that it ...

Physical fitness associated with improved cognition in multiple sclerosis

The benefits of exercise and being physically fit is what many people strive for.  However, a recent study added a new dimension to what exercise can do to enhance health.  In other words, exercise did more than keep a body fit.  It also made study participants think better.  You may ask, why is this new information important?  

 
Cognitive impairment is one of multiple scleroris (MS) ’s most disabling features and it can affect between 22% to 60% of people living with the disease.  Cognitive deficits may include problems with: slower information processing speed; memory impairment; difficulty with new learning and executive functioning.  Historically, medical and rehabilitation approaches to the problem have been inconsistent in improving cognition.
 
The new frontier of exercise for improved cognition provides hope. This study’s objective was to determine if there was an association between improvements in objective measures of physical fitness and performance on cognitive tests.
 
Participants were people with MS who participated in a telephone based health promotion intervention, chose to work on exercise, and who completed pre and post intervention assessments. Participants were then measured for strength, aerobic fitness, and cognition at baseline and 12 weeks later.
 
After controlling for variables such as age, gender, MS disease activity, MS type, etc. there was evidence suggesting that cognitive functioning changed over time based on level of fitness. Participants in the physically improved group showed improved performance on measures of executive functioning after 12 weeks of exercise.  The results of this study add support to the hypothesis that change in fitness is associated with improved executive functioning in people with MS. The desired outcomes are that improved cognition correlates with better quality of life, activities of daily living, vocational endeavors, and rehabilitation measures.
 
Where do we go from here? Since less is known about exercise training and cognition in MS (compared to studies demonstrating aerobic and strength training significantly improving cognitive functioning in older adults and people with mild cognitive impairment), we need more studies to examine this relationship in the MS population. 

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 ...

What you should know about multiple myeloma

Recent news about the health of the distinguished journalist, Tom Brokaw, has focused attention on multiple myeloma, a malignant disease of the bone marrow. Myeloma is characterized by an uncontrolled growth of marrow plasma cells, which normally produce antibodies for our immune system. In its advanced stages, the overgrowth of these cells and their associated proteins can cause anemia, painful bone destruction, and kidney failure.
 
Until about 10 years ago, advanced myeloma was uniformly fatal with a typical survival of about 3 years. Recent years, however, have seen a remarkable improvement in treatment possibilities for myeloma. This began with the discovery that autologous stem cell transplantation could produce complete remissions and longer survival. In addition, a variety of chemotherapy drugs administered in combination with corticosteroid drugs, now produce responses in up to 80% of patients. This means about 80% of patients are surviving longer than 3 years after chemotherapy and autologous stem cell transplant.
 
Not all patients with myeloma require chemotherapy. Myeloma can exist in an early stage for years. This is called smoldering myeloma. Chromosome analysis is routinely done on myeloma cells and allows us to identify patients with more aggressive forms of the disease, and those requiring treatment due to signs of organ damage or bone pain.
 
The Swedish Cancer Institute has been a participant in clinical trials leading to the development of some of the effective new treatments for myeloma. We are currently participating in a study of pomalidomide, a newly approved agent, for patients with relapsed myeloma. Another study offers an investigational drug, MLN9708, for newly diagnosed patients.
 
While the new drugs are more effective and better tolerated than previous chemotherapy, all  ...

Are you at risk for heart disease?

About half of all Americans have at least one of the three main risk factors for heart disease: high blood pressure, high cholesterol and smoking. Other risk factors include diabetes, overweight/obesity, poor diet, inactivity, alcohol use and family history.

More people die from heart disease than any other medical condition. Controlling these risk factors is the most effective method of prevention.

What is your risk for heart disease? Find out by taking a free online Heart Risk Test.

If you need care, we have a team of cardiologists who can evaluate your risk, show you how to reduce that risk, and help you take the first steps to a healthy future.

Five tips for finding a cardiologist:

  1. Convenience. Care close to home or work makes life easier. Swedish has more than 35 cardiologists in 20 locations throughout the Greater Puget Sound area.

  2. Credentials. Cardiologists at Swedish are board certified by their national professional organizations.

  3. Quality. The American College of Cardiology has recognized Swedish cardiologists for being leaders in safe, high-quality care that reduces the risk of death among heart patients. Find out more about our quality outcomes.

  4. Reputation ...

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