MS News That Caught My Eye Last Week: Immunoadsorption, Off-label DMTs, Resistance Training, COVID-19 Vaccines
Columnist Ed Tobias shares the week's top MS news, including a study on benefits of immunoadsorption
This is an interesting study, particularly because of the physical problems that can be caused by significant steroid use over the years. Of course, immunoadsorption is essentially a blood transfusion; it involves collecting a patient’s blood; separating out its liquid component, plasma; and filtering it to selectively remove antibodies. The filtered plasma is then reinfused into the bloodstream. It’s more invasive and expensive than a steroid infusion, and although it’s in use in other parts of the world, it appears it’s not available in the U.S.
A type of blood-cleansing process called immunoadsorption worked better than a second round of methylprednisolone for treating relapse in multiple sclerosis (MS) patients who failed to respond to a first, standard cycle of the corticosteroid, a study found.
Among people with relapsing MS, immunoadsorption also was associated with greater gains in quality of life, and fewer signs of nerve damage, as compared with a double dose of methylprednisolone.
The term “off-label” refers to the use of a medication to treat an illness for which it hasn’t been formally approved. An example would be using Lemtrada (alemtuzumab) to treat primary progressive MS. I’m not surprised that using off-label treatments may be just as effective as using those that have been approved, but I don’t understand why more disease-modifying therapies aren’t approved for progressive types of MS. Maybe it’s just not worthwhile financially to go through the approval process if the meds are going to be prescribed off-label anyway.
Off-label use of high-efficacy disease modifying therapies (DMTs) for people with progressive forms of multiple sclerosis (MS) appear to be as effective as on-label, or approved, DMTs for this MS patient group, a review study from Brazil suggests.
The meta-analysis, which included data from controlled clinical trials, found that rates of disability worsening after two years were similar among patients using on- or off-label treatments when compared with those given a placebo.
I’ve found that this sort of physical training has helped me over the years. There’s no doubt in my mind that working with upper-body weight machines for as little as 45 minutes once a week helps me both physically and mentally. I’ve gotten away from this routine, and I’m trying to get back to it.
Three months of once-weekly sessions of high-intensity resistance training — consisting of strength exercises followed by a short recovery between sets — effectively eased fatigue in multiple sclerosis (MS) patients experiencing low energy and tiredness, a trial in Sweden shows.
This intervention also lessened feelings of depression and anxiety, and improved health-related quality of life. A twice-weekly program resulted in greater effects only in anxiety and psychological aspects of health-related quality of life.
This study hopes to answer some questions that are important to people with MS: How safe are the COVID-19 vaccines for people with MS, and how well do they provide protection over the long haul? The findings may help to create guidelines for dosing and timing COVID-19 vaccines for MS patients taking DMTs. The study is called COVER-MS. I’m participating, and I hope you will, too.
“Understanding the immune response to the COVID-19 vaccine doses in a longer-term study in people with MS will provide tremendous insights into not only optimal vaccine dosing for this population, but it will shed light on how vaccines may affect people with immune disorders or who are taking immunomodulatory therapies,” Bruce Bebo, PhD, the society’s executive vice president of research, said in an ACP press release.
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