January 29, 2019 News by Patricia Inacio, PhD Gilenya Better at Lowering Relapse Rate than Tecfidera or Aubagio, Study Suggests Gilenya is linked to significantly lower annualized relapse rates in relapsing-remitting multiple sclerosis (RRMS) patients compared to Tecfidera orĀ Aubagio, a study suggests. All three therapies showed similar effects on disability outcomes. Oral immunotherapies ā including Novartisā Gilenya, Biogenās Tecfidera, and Sanofi Genzymeās Aubagio ā are currently standard therapies for RRMS treatment. But while these therapies are highly effective at modulating MS activity, studies comparing their efficacy on relapse and disability are missing. This is an important point for MS patients, so that if a change in oral therapies is needed (due to lack of tolerance, for example), the decision on a more suitable therapy is based on scientific evidence. To address this matter, a group of researchers used the MsBase, an international observational MS cohort study, to identify RRMS patients who had been treated with Gilenya, Tecfidera, or Aubagio for at least three months. The team compared Tecfidera versus Aubagio, Gilenya versus Aubagio, and Gilenya versus Tecfidera, specifically for the therapyās impact on relapse activity, six-month disability worsening or improvement, and persistence of treatment. Relapse was defined as the occurrence of new symptoms or exacerbation of existing ones for a period of over 24 hours, at least 30 days after a previous relapse. Disability was assessed using the Expanded Disability Status Scale (EDSS); the six-month disability worsening or improvement were defined as an increase or a decrease by one value in EDSS. The study included 614 patients treated with Aubagio, 782 with Tecfidera, and 2,332 with Gilenya. Patients were followed over a median of 2.5 years. Patientsā characteristics at baseline differed among the three groups. Aubagio-treated patients tended to be older, with longer periods of disease, fewer relapses, and lower EDSS scores compared to the other two groups. Patients treated with Gilenya had higher EDSS and more relapses during the prior year, compared to those treated with Tecfidera. The majority of the patients had been treated with other immunotherapies prior to being given one of these three oral treatments. Results showed that Gilenya-treated patients had significantly lower annualized relapse rates than those treated with Tecfidera (0.20 versus 0.26) or Aubagio (0.18 versus 0.24), while patients taking either Tecfidera or Aubagio had a similar rate. However, during the 2.5-year period analyzed, researchers found no differences in disability accumulation or disability improvement among the three therapies. Regarding treatment persistence, Tecfidera and Aubagio were more likely to be discontinued than Gilenya. Overall, the results suggest that treatment with Gilenya may have a greater impact on relapse frequency in RRMS patients compared to Tecfidera and Aubagio, although the "effect of the three oral therapies on disability outcomes was similar during the initial 2.5 years on treatment," researchers said. āChoosing a therapy in individual patients remains a complex task that requires thorough and individualized evaluation of disease prognosis, and the corresponding risks and benefits of the increasing number of available therapies,ā they concluded.
January 23, 2019 News by Jose Marques Lopes, PhD Favorable Efficacy and Similar Safety with Ocrevus in Relapsing MS, Study Finds Treatment with Ocrevus (ocrelizumab) has superior or comparable effectiveness and a similar safety profile to other available disease-modifying treatments (DMTs) for treating relapsing multiple sclerosis (MS), according to a new review study. The research, āSystematic review and network meta-analysis comparing ocrelizumab with other treatments for…
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 Patricia Inacio, PhD Blood Stem Cell Transplant Better than DMTs at Reducing Risk of Disease Progression in RRMS Autologous hematopoietic stem cell transplant is better than disease-modifying therapies (DMT) at reducing the risk of disease progression in patients with relapsing-remitting multiple sclerosis (RRMS), results from the MIST clinical trial show. The study āEffect of Nonmyeloablative Hematopoietic Stem Cell Transplantation vs Continued Disease-Modifying Therapy on Disease Progression…
January 17, 2019 News by Jose Marques Lopes, PhD Fewer RRMS Patients Relapse, Discontinue Treatment with Gilenya, Study Finds Relapsing-remitting multiple sclerosis (RRMS) patients on Gilenya (fingolimod) have fewer relapses and stay on treatment longer than those takingĀ Tecfidera (dimethyl fumarate) or Aubagio (teriflunomide), according to a new study. The research, āComparison of fingolimod, dimethyl fumarate and teriflunomide for multiple sclerosis,ā was published…
January 14, 2019 News by Larry Luxner Provocative Film Explores Love and Sexuality Among the Disabled Dozens of films have focused on those with diseases or disabilities ā and thereās no shortage of Hollywood productions about love and sex. But only a handful have ever really tried to combine these two themes. āTake a Look at This Heartā does the job with tenderness and finesse.
December 21, 2018 News by Patricia Inacio, PhD Stem Cell Transplant Lessens Disability and Relapses in RRMS Patients, Phase 2 Trial Shows Treatment withĀ autologous hematopoietic stem cell transplantĀ (aHSCT) led to a sustained decrease in disability and almost no clinical relapses in patients withĀ relapsing-remitting multiple sclerosisĀ (RRMS)Ā who had failed to respond to prior immunosuppressive therapies, an Australian Phase 2 trial shows. Trial findings were published in the study, āProspective phase…
December 17, 2018 News by Iqra Mumal, MSc Inactivation of S1PR2 Protein Shows Therapeutic Potential in MS Mouse Model, Study Reports Inactivation of S1PR2, a cell surface protein, helps improve clinical disability and reduce demyelination in a mouse model of experimental autoimmune encephalitis (EAE), a condition similar to multiple sclerosisĀ (MS) in humans, a study shows. This finding suggests that therapies blocking S1PR2 could have the potential to treat MS. The…
December 7, 2018 News by Alberto Molano, PhD Tysabri Seen as Superior to IFN-Ī² in Preventing Relapses, Easing Disability in Small Study Tysabri (natalizumab) was found to be superior to interferon beta (IFN-Ī²) in a small, 12-month study with relapsing-remitting multiple sclerosis (RRMS) patients, significantly decreasing their disability levels, its researchers report. A vast majority ā 90 percent ā of Tysabri-treated patients experienced no relapses during the study period,…
November 28, 2018 News by Patricia Inacio, PhD High Lipid Levels Associated with Increased Disability, Inflammation in RRMS Patients, Study Shows High levels of certain lipids, or fat, in the blood are linked to increased disability scores and high levels of pro-inflammatory markers inĀ relapsing-remitting multiple sclerosis (RRMS) patients, a small study reports. The study, āLipoprotein markers associated with disability from multiple sclerosis,ā was published in the journal Scientific…
November 21, 2018 News by Patricia Inacio, PhD Phase 1 Trial of ATA190 Cell Therapy Shows Promise in Treating Progressive MS Atara Biotherapeuticsā investigational ATA190, a cell therapy that wipes out immune B-cells infected with the Epstein-Barr virus (EBV), led to neurological improvements and reduced symptoms in patients with primary and secondary progressive multiple sclerosis (MS), a Phase 1 trial shows. The trial results were published in the Journal…
October 17, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 – Stem Cell Transplant Effectively Lessens Disability in Patients with Aggressive MS, Study Finds Treatment with autologous hematopoietic stem cell transplant (aHSCT) led to a safe and rapid lessening of disability and no clinical relapses in patients with aggressive multiple sclerosis (MS), according to a new study. The research, āThe use of autologous hematopoietic stem cell transplantation as a…
October 16, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 – Two European Studies Compare Tecfidera, Aubagio Effectiveness Treatment of relapsing-remitting multiple sclerosis (RRMS) patients with Tecfidera (dimethyl fumarate)Ā is associated with fewer new brain lesions at two years, lower relapse rates, increased time to first relapse, and reduced treatment discontinuation than with Aubagio (teriflunomide), according to a nationwide study from France and a real-world, population-based…
October 16, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 – Study Examines Relapses When Stopping Gilenya During, After Pregnancy Up to half of women with multiple sclerosis (MS) who stop treatment with Gilenya (fingolimod) when planning to become pregnant will experience a relapse during pregnancy, according to a new study. The findings also revealed relapses over the first six months after giving birth in a quarter of…
October 12, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018: Study Proposes Serum Neurofilament Light Threshold to Identify RRMS Patients at Risk of Worsening Relapsing-remitting multiple sclerosis (RRMS) patients with serum neurofilament light chain (sNfL) levels higher than a proposed threshold have a higher risk of disease activity, and worsened disability, lesions and brain shrinkage in the long term, according to a new study. The research, āSerum neurofilament light (NfL)…
October 12, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 ā In CIS Patients, Early Lesions in Specific Brain Area Linked to Worse Disability 30 Years Later, Study Shows Lesions in the infratentorial region of the brain at the onset ofĀ clinically isolated syndrome (CIS) and lesions in white matter one year after CIS onset are associated with worse disability 30 years later, a study reports. The study, āEarly MRI predictors of long-term multiple sclerosis outcomes:…
October 11, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 ā Infections, Severe Disability Complications More Likely Causes of Death in MS Patients, Study Shows Infections and complications from severe disability are the greatest contributors to mortality amongĀ multiple sclerosis (MS) patients, according to a population-based study in British Columbia, Canada, which also found that that MS is a more common underlying cause of death among younger patients. The study, āCauses that…
October 11, 2018 News by Ana Pena PhD #ECTRIMS2018 ā MS Patients with Depression or Bipolar Disorder at Higher Risk of Disability Worsening, Study Finds Multiple sclerosis (MS) patients with depression or bipolar disorder may be at higher risk of becoming incapacitated and seeing their disability worsen faster, according to a Swedish study. A depressive state may increase the central nervous system response’s to inflammation and accelerate the…
October 10, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 – Switching to Tysabri Leads to Fewer Relapses and Disability than Gilenya, Study in RRMS Patients Finds Patients with relapsing-remitting multiple sclerosis (RRMS) who switch to Tysabri (natalizumab) after relapses on first-line treatment with other medications show greater relapse reduction and less disability progression than those switching to Gilenya (fingolimod), according to a real-world study. The research, āComparative effectiveness of switching…
October 10, 2018 News by Ana Pena PhD #ECTRIMS2018 – DMTs Slow Down Disability Progression in SPMS Patients with Ongoing Relapses, Analysis Shows Treatment with disease-modifying therapies (DMTs) may benefit patients with secondary progressive multiple sclerosis (SPMS) who are actively experiencing relapses, as they can slow the disability’s worsening, a new analysis of an MS patient registry shows. Patients…
October 8, 2018 Columns by Debi Wilson October Is National Disability Employment Awareness Month Everything can be more challenging when you have a disability, and being part of the workforce can add even more challenges. The month of October is National Disability Employment Awareness Month (NDEAM), and according toĀ the U.S. Department of Laborās website, this year’s theme is āAmericaās Workforce: Empowering All.ā…
October 4, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 – Genentech to Present Ocrevus-related MS Studies at Conference Treatment with Ocrevus (ocrelizumab) over five years lessened upper limb disability progression in primary progressive multiple sclerosis (PPMS) patients, reduced relapses and brain disease activity in patients with relapsing MS, and helped achieveĀ no evidence of disease progression (NEDA) in a greater proportion of African-descent patients, compared to treatment…
September 28, 2018 News by Jose Marques Lopes, PhD #ECTRIMS2018 – Ublituximab Markedly Reduces Lesions, Promotes B-cell Depletion, Halts Disability Progression in Phase 2 Trial A 48-week treatment of relapsing multiple sclerosis (MS) with TG Therapeuticsā investigational compound ublituximab led to a marked reduction of brain and spinal cord lesions, massive depletion of relapse-associated immune B-cells, and significantly halted disability progression, according to results from a Phase 2 clinical trial. The data…
September 20, 2018 News by Vijaya Iyer, PhD Rapamycin, Approved for Other Indications, Potentially Effective for MS, Study Suggests Treatment with Rapacan (rapamycin) decreased the size and volume of brain lesions in patients with multiple sclerosis (MS), an Iranian study reports. The study, āPromising effect of rapamycin on multiple sclerosis,ā was published in the journal Multiple Sclerosis and Related Disorders. Rapamycin, or sirolimus, is an immunosuppressive…
September 11, 2018 News by Ana Pena PhD Truly ‘Benign MS’ Evident in Only Small Minority of Patients, Large UK Study Reports Multiple sclerosis (MS)Ā that appears to be "genuinely benign" 15 years after diagnosis is evident in a small number of patients, a large population-based study from the U.K. reports. But, its researchers note, the term ābenignā is often not clinically accurate as used, because it is based largely on perceptions of disease impact. The study āHow common is truly benign MS in a UK population?ā was published in the Journal of Neurology, Neurosurgery & Psychiatry. The concept of benign MS is controversial, especially among clinicians. Still, long-term epidemiological studies have consistently identified a small fraction of patients whose MS progresses very slowly over a long span of years. Determining the prevalence of this type of MS in the population has been difficult, as estimates can vary significantly depending of the definition of ābenignā that is adopted. Researchers sought to determine an accurate estimate of benign MS in the U.K. population, using a rigorous and comprehensive clinical definition of a truly benign disease. This definition included minimal physical disability (EDSS scoreĀ of less than 3), and no significant fatigue, mood disturbance, cognitive impairment or interrupted employment in the absence of treatment with disease-modifying therapies over 15 years or more years after symptom onset. They screened an U.K. population-based registry containing data on 3,062 MS patients to identify those with "unlimited walking ability" 15 or more years after diagnosis. A representative sample of 60 patients Ā from this pool was analyzed (45 women and 15 men, mean age of 57); they had a mean disease duration of 28 years. Nine out of these 60 (15%; 8 women and one men) fulfilled the studyās criteria for truly benign disease. These nine people had a mean age of 27 at symptom onset, a median EDSS disability score of 1.5 (minimal signs of disability), and a mean disease duration of 31 years. "Those nine individuals with truly benign MS all remained in a relapsingāremitting state," the study noted. "However, only two out of nine showed disease arrest within the first decade; the remainder all continued to experience relapses well into their second or third decade of MS," but the rates of such relapses were low. MS in the remaining patients was not classified as benign, mostly due to evidence of cognitive difficulties (57%), and the disease's impact on employment status (52%) with many taking early retirement. Based on these results, a population frequency for "benign MS" under the definitions used was estimated at 2.9%. But the researchers noted that a large proportion of patients (65%; 39 patients out of 60) reported their disease as benign, according to a lay definition. Their self-reported status poorly agreed with the clinical assessments done throughout the study. "There is no accepted definition to offer patients when exploring whether they feel their MS is benign; the definition we chose incorporates the fundamental principles of low impact on a person, absence of complications and a favourable outcome and is in line with definitions provided by third-party support groups," the researchers wrote. Many Ā considering themselves with benign disease did so based on their "perception" of their disease, the team added, and one that "appeared to be driven as much by mood, fatigue and bladder function as by physical ability."Ā āIn conclusion, after detailed clinical assessment, a small minority of people with MS appear genuinely unaffected by symptoms after 15 years,ā the researchers added. They also called attention to the fact that EDSS-based definitions of benign MS and the inconsistency between patient and clinician perception of benign MS compromise the use of the term ābenignā in clinical practice. They also emphasize that studying individuals with benign MS āhas the potential to uncover clues to mechanisms underlying favorable outcomes in MS, provide insights into new therapeutic targets and have implications for patient counselling, individual patient management and the construct of clinical trials.ā
September 4, 2018 News by Jose Marques Lopes, PhD Smoking Aggravates Respiratory Complications, Increases Sedentary Lifestyle in MS Patients, Study Reports Cigarette smoking worsens shortness of breath and fatigue, increases the rate of hospital admissions, and fosters a sedentary lifestyle in patients with multiple sclerosis (MS), according to a new study. The research, āEffects of cigarette smoking on respiratory problems and functional levels in multiple sclerosis patients,ā…
August 15, 2018 News by Patricia Inacio, PhD Long-term DMT Use Seen to Lower Likelihood of RRMS Progressing to SPMS in Study Long-term treatment with disease-modifying therapies (DMTs) appears to lessen the risk of disease worsening inĀ relapsing-remitting multiple sclerosis (RRMS) patients, an 18-year follow-up study suggests. But these therapies were not seen to benefit those who had progressed to secondary progressive multiple sclerosis (SPMS). The study, āOnset of secondary…
July 19, 2018 News by Patricia Inacio, PhD Brain Iron Levels Correlate with MS Progression, Disability Risk, Study Shows Evaluating the local differences in iron accumulation in the deep gray matter of the brainĀ using a specialĀ magnetic resonance imaging (MRI) technique, may help identify multiple sclerosis (MS) patients at greater risk for disease progression and disability, a study reports. The study “Brain Iron by Using Quantitative MRI…
June 21, 2018 News by Alice MelĆ£o, MSc #EAN2018 – Pupil Response to Light Linked to RRMS Duration and Severity in Study Measuring the response of the pupil to light stimulating the eye is a non-invasive and easy way to assess multiple sclerosis (MS) severity and progression, researchers report. A clinical study found that poor, or dysfunctional, pupil response was associated with longer disease duration and greater disease severity inĀ relapsing-remitting multiple…
June 18, 2018 News by Vijaya Iyer, PhD First Clinical Trial to Focus on Improving Hand Function in PPMS Patients Announced A new clinical trial will be the first in the world to recognize the importance of retaining hand function for wheelchair-bound patients with primary progressive MS (PPMS), according to a press release from Queen Mary University of London. The international trial, which will be conducted by a…