MS News That Caught My Eye Last Week: Fasting Study, ‘Bad’ T-cells, Brain Volume, Ocrevus in Scotland

Missouri Trial to Examine if Fasting Alters Gut Microbiome and Immune System of RRMS Patients in Helpful Ways

The impact of various diets on multiple sclerosis (MS) has been studied, but this new study will look into whether fasting has an impact. The researchers at Washington University in St. Louis, Missouri, are enrolling 60 RRMS patients. (Information about volunteering is included in the full story.)

A 12-week clinical study is recruiting people with relapsing-remitting multiple sclerosis (RRMS) to evaluate if intermittent fasting can improve their immune response, metabolism, and gut microbiome — the bacterial community that inhabits the gastrointestinal tract.

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Overreactive T-cells Can Transition into T-cells That Control the Immune Response, Study Shows

Researchers have long believed that rogue T-cells may play a part in the development of multiple sclerosis. In fact, the disease-modifying therapy Lemtrada (alemtuzumab) kills certain bad T-cells with the hope that the body will replace them with T-cells that are normal. This story reports on research showing that there may be ways to manipulate these bad T-cells so that they become good T-cells.

New research shows that overreactive and tissue-damaging T-cells can transition into regulatory T-cells that help to control the immune system’s response.

These findings open the door to further understanding of the mechanism underlying this transition; providing knowledge that can help scientists in designing more effective, targeted immunotherapies for diseases like MS.

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Rate of Brain Volume Loss Not Adequate as Marker of Treatment Effectiveness in MS Patients, Study Reports

Researchers are reporting that the amount of brain volume loss in people with MS is inconsistent over time. They also report that brain volume loss (BVL) appears to be directly associated with the use of steroids. And they think that MRIs may miss some early loss of brain volume. Doctors have used BVL as one way to measure the efficacy of a particular treatment. But, based on what they’ve found in this study, these researchers suggest that measuring BVL may not be the best way to measure the efficacy of a particular treatment.

Brain volume loss takes place at a faster rate in the first five years of MS than later in the disease course, researchers report in a study that calls for scientists to “reconsider” — for this and related reasons — proposals to use volume loss as a measure of treatment efficacy in MS patients.

The study, “Assessing Biological and Methodological Aspects of Brain Volume Loss in Multiple Sclerosis,” was published in the journal JAMA Neurology.

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NICE Agrees to Add Ocrevus to NHS for RRMS Patients in England and Wales, But Scotland Will Not

What’s up with this? People with relapsing MS in England and Wales have Ocrevus available to them, but the same patients in Wales do not. If the NICE reviewers who recommend treatments to the U.K.’s National Health Service for patients England and Wales found Ocrevus to be cost-effective, why wouldn’t the same hold true for reviewers at the Scottish Medicines Consortium – which just gave a thumbs-down to this medication? Does that make sense to you?

Relapsing-remitting multiple sclerosis (RRMS) patients with active disease may now be treated with Ocrevus (ocrelizumab, developed by Genentech) within the National Health Service (NHS) — the subsidized public health system that covers England and Wales. But those in Scotland will not.

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