February 11, 2019 News by Jonathan Grinstein Petition Urges NHS England to Make Ocrevus Available for PPMS Patients More than 21,000 people have signed a petition calling for Ocrevus (ocrelizumab) to be made available by the National Health Service (NHS) in England for people with primary progressive multiple sclerosis (PPMS). According to an MS Trust press release, the…
February 8, 2019 News by Jonathan Grinstein #ACTRIMS2019 – Upcoming Forum Will Include Interactive, Case-based Discussion About MS Therapeutic Landscape The Physicians’ Education Resource will host an interactive, case-based discussion on the latest therapeutics in multiple sclerosis (MS). The free educational program, part of the 2019 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum (Feb. 28 -March 2), aims to inform…
February 7, 2019 News by Jonathan Grinstein Discovery of Immune Cell Subtypes in Mice is an MS ‘Breakthrough,’ Researcher Says Previously unknown immune cell subtypes are present in the inflamed brain of mice models of multiple sclerosis (MS), a new study reports. According to the researchers, these subsets of myeloid cells (cells derived from hematopoietic stem cells in the bone marrow) can offer a strong basis for therapeutic targets in neuroinflammatory and…
February 6, 2019 News by Jonathan Grinstein Traditional Dysphagia Therapy Improves Swallowing Function in MS Patients, Pilot Study Shows Rehabilitation using traditional dysphagia therapy improved swallowing function in multiple sclerosis patients with dysphagia, a pilot study shows. The research article with that finding, “The effect of traditional dysphagia therapy on the swallowing function in patients with Multiple Sclerosis: A pilot double-blinded randomized controlled trial” was…
February 5, 2019 News by Jonathan Grinstein MS May Raise Risk of Deep-vein Blood Clots, Possibly by Limiting Mobility, Study Says People with multiple sclerosis may be twice as likely to develop deep-vein blood clots, a condition known as venous thromboembolism, than healthy people do, a study reports. But data linking the two is limited, and its researchers say further work is needed to understand if MS is directly related to…
February 4, 2019 News by Jonathan Grinstein Gait Disorders and Depression at Onset May Delay Time to MS Diagnosis, Study Finds Awareness of certain symptoms, particularly gait disorders and depression, could be critical for reducing the time it takes to diagnose multiple sclerosis after a patient first contacts a healthcare provider, research shows. In the past 30 years, there has been a major decrease in the time from the…
February 1, 2019 News by Jonathan Grinstein Medication Use in RRMS Patients Highlights Importance of Better Treatment Management, Study Says Patients with relapsing-remitting multiple sclerosis, particularly those with multiple conditions who are more severely disabled, are more likely to be using several medications at the same time, a study shows. These findings highlight the need for physicians to be aware of what medications their patients are taking to avoid…
January 31, 2019 News by Jonathan Grinstein Anxiety and Depression Linked to Cognitive Issues in MS, Other Diseases, Study Finds Anxiety and depression are associated with lower cognitive abilities in patients with multiple sclerosis (MS) other and immune-mediated inflammatory diseases such as inflammatory bowel disease (IBD) and rheumatoid arthritis, a study shows. These findings indicate the importance of managing symptoms of anxiety and depression in MS, as…
January 30, 2019 News by Jonathan Grinstein Canadian RRMS Patients Less Likely to Discontinue Treatment with Oral Gilenya, Compared to Injectable or Infusible Therapies Multiple sclerosis (MS) patients in Canada are more likely to comply with their treatment plan and less likely to discontinue the use of the oral disease-modifying treatment Gilenya (fingolimod), compared to injectable or infusible treatment options, new research shows. The research article with that finding, “A…
January 28, 2019 News by Jonathan Grinstein Decline in Brain Volume Driven by Gray Matter Atrophy in MS Patients Despite Tysabri Treatment The progressive decline in brain volume in multiple sclerosis (MS) patients, despite treatment with the disease-modifying therapy Tysabri (natalizumab), is driven by atrophy — shrinkage due to the degeneration of cells — in gray matter and not white matter structures, a new study reports. This finding points to new markers…
January 28, 2019 News by Jonathan Grinstein Altered Oligodendrocyte Diversity Contributes to Multiple Sclerosis, Study Suggests Subpopulations of oligodendrocytes — cells that produce the myelin sheath that protects nerve fibers — are altered in patients with multiple sclerosis, a study shows. These findings suggest that oligodendrocyte diversity and the different functions of these subpopulations might have a greater role in the disease than previously thought. The severity of MS varies greatly, and the patient's disability level does not correlate well with the degree of myelin loss. This suggests that other factors contribute to MS severity. One such factor may be that oligodendrocytes are heterogeneous — diverse in makeup and function. For example, oligodendrocytes in mouse spinal cords are known to naturally produce longer myelin sheaths than oligodendrocytes in the mouse brain. Additionally, individual oligodendrocytes have been shown to have different molecular makeups. However, the extent of human oligodendrocyte diversity and its possible contribution to MS pathology remains unknown. Researchers from the Karolinska Institutet and the MRC Centre for Regenerative Medicine studied the differences of individual human oligodendrocytes from healthy and MS brains to assess their diversity. Specifically, the team examined oligodendrocytes from the white matter areas of post-mortem human brains both from MS and non-MS patients. The team examined the RNA content — the messenger molecule carrying instructions from DNA for the production of proteins — from individual oligodendrocytes. Researchers identified groups of RNA molecules that defined features of oligodendrocytes from healthy human white matter. Some of these groups match those that defined oligodendrocytes in healthy mice. Strikingly, some of these RNA molecules in healthy brains were under-represented in oligodendrocytes from MS brains, whereas others were more prevalent. “We found that oligodendrocytes are a diverse population of cells and that different types are likely to have different functions in the brain,” Charles ffrench-Constant, the study's co-lead author, said in a Karolinska Institutet news release written by Katarina Sternudd. These differences in oligodendrocyte RNA content may indicate different functional states of oligodendrocytes in MS lesions. “The proportions of different resident oligodendrocytes in the lesions are changed, along with their properties, suggesting that they might have important roles in MS,” said Eneritz Agirre, PhD, a study co-author. Furthermore, the researchers believe that this altered diversity in oligodendrocytes in MS may be important to understand disease progression and develop therapeutic approaches. “Understanding which types of oligodendrocytes are most beneficial in repairing myelin will be crucial for maximizing the chances of developing much-needed treatments for MS,” said Anna Williams, PhD, study co-lead author. The team concluded that the changes in different oligodendrocyte subpopulations in MS suggest "a more complex role of these cells in the pathology of the disease, but also in regeneration of new cells,” said Gonçalo Castelo-Branco, PhD, another study co-lead author.
January 25, 2019 News by Jonathan Grinstein Positive Safety Data Reported for High-dose MS Treatment Candidate Temelimab GeNeuro has reported positive data from a Phase 1 clinical trial (NCT03574428) evaluating the safety and tolerability of high doses of GNbAC1, developed for the treatment of neurological and autoimmune disorders, including multiple sclerosis (MS). The company also announced that the World Health…
January 24, 2019 News by Jonathan Grinstein New Products Intended to Stimulate Feet of MS Patients Naboso Technology has expanded its product offerings with new insoles and training mats specifically designed to stimulate the nervous system through the skin on the bottom of the feet. The products were developed to help improve balance, posture, movement and restore motor function, as part of a neurorehabilitation strategy…
January 23, 2019 News by Jonathan Grinstein Novartis, Oxford’s Big Data Institute Team to Better Understand, Treat Complex Diseases Novartis and the University of Oxford’s Big Data Institute (BDI) have established an alliance to advance the use of medical data for spotting disease patterns and assessing patients’ responses to treatment. The initiative seeks to enable more informed clinical decision-making and improve the development of treatments for complex diseases.
January 22, 2019 News by Jonathan Grinstein Certain Treatments Linked to Lower Risk of Secondary Progressive MS, Study Shows Initial treatment of relapsing-remitting multiple sclerosis (RRMS) with Gilenya (fingolimod), Tysabri (natalizumab), or Lemtrada (alemtuzumab) is associated with a lower risk of conversion to secondary progressive multiple sclerosis (SPMS), compared with interferon beta or Copaxone (glatiramer acetate), a study reports. Findings also showed that…
January 21, 2019 News by Jonathan Grinstein Fatigue More Common in Progressive MS Patients, Survey Shows Fatigue is more prevalent among patients with progressive multiple sclerosis (MS), according to a study that surveyed patients on fatigue and factors related to it. In addition, increased fatigue severity correlated with greater physical, cognitive, and psychological impairment, although the strength of this link was largely the same…
January 18, 2019 News by Jonathan Grinstein Small Molecule Shows Ability to Limit Autoimmune Response in MS, Mouse Study Reports A small molecule called Sephin1 may be able to significantly delay harm to neurons in multiple sclerosis (MS) by protecting oligodendrocytes, limiting the autoimmune response, a mouse study reports. The study, “Sephin1, which prolongs the integrated stress response, is a promising therapeutic for multiple sclerosis,” was published in the journal Brain. MS is thought to be caused by immune-mediated inflammation that damages the myelin — an insulating sheath around nerve cells. For this reason, current MS disease-modifying treatments focus on immune-mediated inflammation. Although these treatments moderate disease relapses, their impact on disease progression is unclear. Previous studies have demonstrated that oligodendrocytes — cells that produce myelin — are critical in protecting against neuron demyelination and axon (nerve fiber) damage. As a result, researchers have been keen to develop alternative therapeutic approaches that protect oligodendrocytes, and ultimately limit disease progression. A signaling pathway called integrated stress response that acts as a natural defense system to protect cells has been shown to reduce the inflammatory impact on oligodendrocytes. This response is triggered by phosphorylation (a chemical reaction) of a protein called eukaryotic initiation factor 2 alpha (eIF2α), and reduces the total production of proteins, instead promoting the synthesis of protective proteins in the cells. Conversely, the integrated stress response can be cut off by dephosphorylation of eIF2α. Sephin1 was shown to inhibit the dephosphorylation of eIF2α, prolonging the protective response. In this study, researchers at the University of Chicago proposed that Sephin1, by producing this response, could protect oligodendrocytes and slow the progress of the disease. The team tested their hypothesis in a mouse model called experimental autoimmune encephalomyelitis (EAE), which is similar to MS in humans. Results showed that treatment with Sephin1 did inhibit eIF2α dephosphorylation in EAE mice, triggering a protective response against inflammation. More importantly, myelin-producing oligodendrocytes were also protected, and disease onset was significantly delayed. This correlated with diminished oligodendrocyte loss, protected neuronal axons and myelin, and prolonged integrated stress response. In addition, Sephin1 decreased the levels of inflammatory immune T-cells, and the production of inflammatory signals within the central nervous system. "By protecting oligodendrocytes and diminishing demyelination, we also reduce the generation of myelin debris," Brian Popko, PhD, the study's senior author, said in a press release. "The decreased exposure to myelin fragments should also limit the auto-immune response." Popko is the Jack Miller professor of neurological disorders, and director of the Center for Peripheral Neuropathy at the University of Chicago. The effects of Sephin1 were also combined with interferon-beta treatment — an anti-inflammatory first-line MS therapy. Researchers found that the combination was more effective than the therapies given separately. "Encouragingly, adding Sephin1 to the established anti-inflammatory MS drug interferon beta provided additive benefits to the mouse MS model," said study co-author Yanan Chen, PhD, a postdoctoral fellow in the Popko laboratory. The team concluded that the results "suggest that a neuroprotective treatment based on the enhancement of the integrated stress response would likely have significant therapeutic value for multiple sclerosis patients." Treatment with Sephin1, they say, "could lead to a better clinical outcome in multiple sclerosis patients as a safe neuroprotective drug, perhaps when used in combination with immune-modulatory therapies." Sephin1 has been patented and licensed to InFlectis BioScience, a French biotech company.
January 16, 2019 News by Jonathan Grinstein Researcher Wins Barancik Prize for Study of Blood Factors’ Role in MS Katerina Akassoglou, PhD, a leading neurology researcher at the Gladstone Institutes at the University of California, San Francisco (UCSF), won the 2018 Barancik Prize for Innovation in Multiple Sclerosis Research. Akassoglou will receive the award and deliver the Prize lecture at the Americas Committee for Treatment…
January 14, 2019 News by Jonathan Grinstein Tecfidera Effective in East Asian RRMS Patients, Phase 3 Trial Shows Tecfidera (dimethyl fumarate) demonstrated strong efficacy in Japanese and other East Asian patients with relapsing-remitting multiple sclerosis (RRMS), a Phase 3 clinical trial shows. These results are consistent with previous clinical trials, which included mostly white MS patients, and show that Tecfidera can also be effective across various other patient demographics. Findings of the trial were reported in the study, “A randomized placebo-controlled trial of delayed-release dimethyl fumarate in patients with relapsing-remitting multiple sclerosis from East Asia and other countries,” in the journal BMC Neurology. Tecfidera, a delayed-release dimethyl fumarate capsule, marketed by Biogen, is an oral therapy approved in many parts of the world for the treatment of RRMS. In previous Phase 3 clinical studies, DEFINE (NCT00420212), and CONFIRM (NCT00451451), Tecfidera showed substantial effectiveness on clinical and neuroradiological measures in RRMS patients. The study participants were predominantly white (79% in DEFINE and 84% in CONFIRM), and there were 10% or fewer East Asian patients. In general, very little data is available on Tecfidera's effectiveness in East Asian MS patients. In this APEX Part 1 (NCT01838668) trial, researchers from the Kansai Medical University in Japan and Biogen evaluated the safety and efficacy of Tecfidera over 24 weeks (six months) in the treatment of RRMS patients from East Asia and other countries. Participants with active MS between the ages of 18 and 55, with ethnic origins in Japan, South Korea, or Taiwan were included. To compare East Asian and white MS patients, study enrollment was expanded to patients from Eastern Europe (Czech Republic and Poland). In all, the six-month, double-blind, placebo-controlled study recruited 225 patients, 142 of whom were East Asian (63.4%). It was completed by 213 participants. Patients were randomly assigned to receive Tecfidera, (240 mg, twice daily) or a matching placebo for six months. They were assessed at the beginning of the study, at three months, and again at six months. They underwent MRI (magnetic resonance imaging) scans for neurological examination, in addition to routine health checks. The primary objective of the study was the total number of new inflammatory lesions on brain MRI scans from three to six months. Secondary goals included the number of specific new, or newly enlarging T2 hyperintense lesions — lesions reflective of damage to nerve cell connections — from the beginning of the study to six months. Tertiary goals included standard safety measurements, and annualized relapse rate over six months. “We chose radiological measures to serve as primary and secondary endpoints, due to the ability of MRI to detect lesions that might not produce clinical manifestations in the short-term,” the researchers wrote. Results showed that Tecfidera treatment significantly reduced (84%) the total number of new MRI lesions from weeks 12 to 24 (primary objective), compared with placebo — specifically by 85% in the Japanese subgroup, 81% in the total East Asian subgroup, and 87% in the Eastern European subgroup. Regarding the trial's secondary objective, the total number of new MRI lesions from the beginning of the study up to six months was reduced by 75% in the Tecfidera group (78% in the Japanese, 76% in the East Asian, and 73% in the Eastern European subgroups), and the mean number of new/newly enlarging T2 hyperintense lesions was reduced by 63% in the Japanese, and 58% in the East Asian subgroups, compared with placebo. Most patients reported one or more adverse events (77% in the placebo group and 86% in the Tecfidera group). Most adverse events were mild or moderate in severity, and the ones affecting patients taking Tecfidera either related mainly to flushing symptoms or to gastrointestinal problems. The team concluded that the "results suggest that the strong efficacy and favorable benefit-risk profile of [Tecfidera] extends to Japanese and other East Asian patients with MS." The second part of the ongoing clinical trial, APEX Part 2, is an open-label extension trial — where both the researchers and participants know which treatment they are getting — designed to further examine the long-term safety and tolerability of Tecfidera in East Asian MS patients.
January 10, 2019 News by Jonathan Grinstein Targeting Gut Immune Cells May Alleviate Brain Inflammation in MS, Study Suggests A type of immune cell from the gut can reduce brain inflammation in people with multiple sclerosis (MS), and increasing the numbers of these cells in a mouse model of the disease halts inflammation completely, new research reports. These findings were reported in the study, “Recirculating…
January 9, 2019 News by Jonathan Grinstein BrainStorm Expands Production of Autologous Stem Cell Therapy NurOwn for Phase 2 Trial in Multiple Sclerosis BrainStorm Cell Therapeutics announced that the production of its therapy NurOwn will be expanded to support upcoming clinical trials, namely a Phase 3 trial in amyotrophic lateral sclerosis (ALS) and a Phase 2 trial in progressive multiple sclerosis (MS). BrainStorm’s proprietary, stem cell-based technology called…