MS News that Caught My Eye Last Week: Palliative Care, Lemtrada and Lung Bleeding, Stroke Risk, Rebif Report
Palliative care emphasizes prevention and relief of a patient’s suffering. Its goal is to improve the quality of life of that patient and his or her family. It’s usually thought of in regards to seriously ill cancer patients, and I’m pleased to see that its use is on the rise when the situation dictates it for people with MS.
Palliative care in a hospital setting rose 30-fold among multiple sclerosis (MS) patients in the U.S. from 2005 to 2014, and was associated with longer hospital stays and greater numbers of in-hospital deaths but also lower overall costs, according to a large data study.
Increased reliance on such care was particularly evident after 2010 and partly attributed to the passage of the Affordable Care Act, the healthcare reform law enacted in March of that year.
This headline is a little unclear, so let me try to help. One woman being treated with Lemtrada (alemtuzumab) is reported to have suffered bleeding in her lungs. A case study was conducted and is reported in this story. Four other Lemtrada patients are reported to have suffered the same lung bleeding, but no studies have been published about these cases. In all five patients, the problems occurred during their first round of treatments, following their second infusion.
Her medical team found diffuse alveolar hemorrhage in this patient — which resolved in about a week without treatment. The scientists advised that clinicians be alert to signs of lung bleeding, such as sudden onset of respiratory distress or coughing up blood, in MS patients using Lemtrada.
Another possible side effect of Lemtrada was reported in the past week. But a key word in this advisory is “rare.” Only about a dozen cases have been reported over the past four years. MS patients need to know about this, but we also need to put this advisory into perspective and then add it to the information we consider when weighing the benefits of this medication against its risks.
The U.S. Food and Drug Administration (FDA) has issued a safety alert, warning about a rare, but life-threatening, risk of stroke and artery rupture in patients with relapsing forms of MS being treated with Lemtrada.
Since the medication’s approval in 2014 to treat relapsing MS, 13 cases worldwide of ischemic stroke (caused by clots) and hemorrhagic stroke (caused by bleeds) or of tears in the lining of arteries in the head and neck have been reported to the FDA. All of these cases are associated with the medicine’s use.
Rebif gets good marks in this small 64-person study. But note: As we mention in our report, the study was paid for by Merck Hellas, a branch of the company that developed Rebif.
Patients with RRMS on Rebif (interferon beta- 1a), using the RebiSmart autoinjector, have high treatment adherence, despite seasonal weather or temperature fluctuations, as well as fewer relapses over one year, a real-world study reports.
The study, “Seasonal adherence to, and effectiveness of, subcutaneous interferon β-1a administered by RebiSmart in patients with relapsing multiple sclerosis: results of the 1-year, observational GEPAT-SMART study,” was published in the journal BMC Neurology.
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