February 25, 2015
As long as the cause of multiple sclerosis (MS) remains unknown, it will be tempting – for patients and doctors alike – to search for an explanation among events that occurred before the diagnosis. This approach, known from antiquity as post hoc, ergo propter hoc (after the fact, therefore because of the fact), though sometimes successful, can also be misleading. History of science in general, and multiple sclerosis in particular, is rife with such fallacies. It is important to remember then, that this approach is best thought of as “brainstorming”, generating potential leads, but (almost) never the definitive proof.
December 29, 2014
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.
October 21, 2014
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 ..
March 22, 2014
The Swedish MS Center is proud to participate in the annual Multiple Sclerosis Walk organized by the National MS Society. The annual MS Walk raises awareness of multiple sclerosis in our community and also raises funds for new cutting-edge research and life changing programs and services of the National MS Society Greater Northwest Chapter. The NMSS Greater NW Chapter serves more than 15,000 people with MS living in Alaska, Montana and Central and Western Washington.
The Swedish MS Center has formed a Walk MS team to join in the fundraising efforts. Anyone is welcome to join the team-patients, friends, family or concerned community members. By joining, you can make a powerful statement and real difference for people living with multiple sclerosis. The money raised by the team will give hope to thousands of people living with MS in the Northwest. Join or donate to the team now!
March 21, 2014
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 ...
November 22, 2013
The 2013 World Atlas of MS has been published by MS International Foundation and is available here. The key findings are:
- The estimated number of people with MS has increased from 2.1 million in 2008 to 2.3 million in 2013
- The 2:1 ratio of women to men with MS has not changed significantly since 2008
- Substantial global inequalities remain in terms of access to treatment and medical care
September 05, 2013
A survey from the United Kingdom published in the Journal of MS and Related Disorders polled 396 people with multiple sclerosis (MS) about how they would like to be referred to in conversation. The winning term ("MSer") was supported by 43% of the respondents, while "person with MS" received 34% votes. When a United States-based blog reported on the story, 2 out of 3 respondents disagreed.
What do you think? Comment below with your preference and why.
(Ed. note: You can comment anonymously - feel free to use your initials if you are more comfortable sharing that way.)
August 10, 2013
A couple recent announcements may be of interest to people living with multiple sclerosis. Read the articles below and click through the links for more information about the individual studies.
Trial shows no benefit of cannabinoid in slowing multiple sclerosis progression
A UK trial of dronabinol (delta-9-THC) in 498 patients did not slow the progression of multiple sclerosis (MS) compared to placebo. Critics will point out that this is only one of many cannabinoids found in marijuana; and that the placebo arm did better than expected (thus limiting the ability to detect the effects of the drug). Nonetheless, the result is the strongest argument yet against the neuroprotective effects of THC in MS population.
New trials in progressive MS are coming
Later this year, two trials will ...
May 14, 2013
Cognitive dysfunction in multiple sclerosis (MS) is a recognized, but poorly understood phenomenon. Detection of cognitive dysfunction is hampered by the fact that cognitive testing is often long, sometimes costly and at times frustrating for patients. A brief, acceptable screening tool for cognitive dysfunction in MS is lacking.
A new study shows potential progress toward such a tool. Authors of a paper published in the Multiple Sclerosis Journal describe a 10-minute battery of computerized tests that was able to identify with fairly good sensitivity those patients who experienced cognitive impairment. This study, like several other similar efforts, awaits verification before they are more broadly accepted. It is hoped that such tools will come at no or minimal cost to the patients.
Identifying cognitive dysfunction early may be importan...
September 18, 2012
On September 12, 2012, the Food and Drug Administration (FDA) approved teriflunomide for the treatment of multiple sclerosis (MS). Teriflunomide (AUBAGIO) is a once-daily pill for the treatment of relapsing forms of MS. Led by Dr. Lily Jung Henson, the Swedish Neuroscience Institute was among several clinical sites that tested the drug. Results of the research showed that teriflunomide can lessen MS disease activity. Specifically, it behaves similarly to injectable therapies by slowing MS relapse frequency, the rate of disability and MRI activity.
The safety profile, however, is more challenging than ....
May 16, 2011
Considering that multiple sclerosis (MS) affects primarily women of childbearing age, it comes as no surprise that for many patients MS and pregnancy often occur together. The issues to consider when discussing pregnancy and MS include:
- How pregnancy affects MS
- How MS affects pregnancy
- How MS treatment should be managed throughout pregnancy
The Pregnancy in MS (PRIMS) study of 254 patients revealed that pregnancy is generally protective against MS relapses, in particular during the third trimester. In contrast, the same study found a rebound of relapses during three months post delivery, with 30 percent of women experiencing a relapse within three months after delivery. Several strategies have been proposed to avert the risk of postpartum relapse, including the use of pro...