disease progression

Oxcarbazepine, an anti-epileptic medicine, given in combination with a disease-modifying therapy (DMT) may help to stop disability progression in multiple sclerosis (MS) patients, results of Phase 2 trial suggest. Monica Marta, PhD, with Queen Mary University of London and Barts Health NHS Trust/The Royal London Hospital presented the data at the…

Transplanting mesenchymal stem cells (MSCs) is safe and can delay disease progression in people with active, progressive multiple sclerosis (MS), according to results from a single-center clinical trial conducted in Israel. Six months after the transplant, a considerable proportion of patients showed no signs of disease activity, compared to…

Multiple sclerosis (MS) experts discuss disease causes and current treatment options in a new video series released by the multimedia and peer-reviewed science journal, The American Journal of Managed Care (AJMC).  The free and online video series is part…

Monthly injections of ofatumumab led to more clinically meaningful reductions in relapse rates and delayed disability progression than did daily treatment with Aubagio (teriflunomide) tablets in people with relapsing forms of multiple sclerosis (MS), results from two Phase 3 trials showed. Ofatumumab, formerly known as OMB157, is a potent, self-administered…

The complexity in underlying mechanisms, a lack of representative research models, and inconsistent criteria defining therapeutic benefit are the main reasons why an effective therapy for progressive forms of multiple sclerosis (MS) is still lacking, researchers maintain in a review study. Nevertheless, as research continues to shed light on…

Dark Rimmed Brain Lesions May Be Signal of Aggressive Disease, NIH Study Says Researchers in this study found that specific brain lesions, notable for their dark rims, may indicate that a patient’s multiple sclerosis is likely to progress quickly. They suggest that early detection of these lesions can help…

The presence of chronic active lesions in the brain may provide a clue as to how quickly multiple sclerosis (MS) symptoms will progress. Researchers at the U.S. National Institutes of Health (NIH) call these lesions “smoldering inflammation.” Their study, just published in JAMA Neurology, indicates that the more lesions…

Brain lesions appearing as dark rimmed, “smoldering” spots on imaging scans, representing active inflammation, may be a hallmark of more aggressive and disabling forms of multiple sclerosis (MS), researchers at the National Institutes of Health (NIH) report. Using a powerful MRI brain scanner and a 3D printer, the…

Routine screening through magnetic resonance imaging (MRI) of people with multiple sclerosis (MS) can predict long-term disease progression — leading to more certainty and informing better treatment choices, a 15-year study reported. The study, titled “Early imaging predictors of long-term…

Early and continuous treatment with Gilenya (fingolimod) in young  people — those ages 30 years or younger — with relapsing-remitting multiple sclerosis (RRMS) decreases the risk of disability progression, and lowers annual relapse rates and brain lesions, new analysis from the FREEDOMS and FREEDOMS II trials show. The…

The cerebrospinal fluid (CSF) of people with progressive multiple sclerosis (MS) contains elevated levels of specific fatty molecules that disrupt the energy “powerhouses” of nerve cells, and appear to underlie the neurodegeneration seen on brain scans of these patients, a study reveals. The research, which compared the CSF…

A new radiotracer called [F-18]PBR06, used in positron emission tomography (PET) imaging, helps detect changes in the brain’s grey matter that are linked to progressive forms of multiple sclerosis (MS), a study shows. The findings support [F-18]PBR06’s potential for detecting signs of disease progression even before patients show…

Even at a low level of disability, people with multiple sclerosis (MS) have substantial indirect and informal caregiving costs due to disease progression — with unemployment markedly adding to the economic burden, a Spanish study reports. The study, “Economic burden of multiple sclerosis in a population with low physical disability,” was published in the journal BMC Public Health. MS has significant impact on health-related quality of life, with disability and fatigue — two hallmarks of the disease — hindering patients' ability to work or study. This often results in early unemployment. As MS progresses, many individuals often need the support of caregivers to perform daily life activities. Limited information is available on MS-associated economic burden imposed on patients by the costs of informal care and loss of employment. To fill this gap, Spanish researchers evaluated the cost burden of indirect and informal care for 199 people with MS. Participants (mean age 43.9 years, and 60% females) were followed at 19 MS clinical units across Spain. Among the participants, 172 (86.4%) had relapsing-remitting MS, and 27 (13.6%) had primary progressive MS. The Expanded Disability Status Scale (EDDS) was used to determine each individual’s level of disability. EDDS scoring is done by a trained neurologist, who quantifies a patient’s disability on a scale of zero to 10, in 0.5 increments.  EDDS also is used to monitor changes in disability levels through the course of MS. The greater the EDDS score, the higher the disability level. The team used the 23-item MS Work difficulties questionnaire (MSWDQ-23) to assess the level of hardships participants experienced at their workplace. A patient-reported survey, the questionnaire highlights the extent of psychological and cognitive, physical, and other external difficulties experienced at work by people with the disease. MSWDQ-23 scores range from zero to 100, with a higher score correlating to more significant workplace difficulties. The study population had a median EDDS score of 2, and a median MSWDQ-23 score of 31.5, indicating an overall low level of physical disability. Despite this, MS was found to have a marked impact on the individuals’ work and academic activity. At the time of MS diagnosis, 70.6% of the participants were employed. However, at the start of this study, 9.6 years later, the employment rate among the participants had dropped to 47.2%. The retirement rate increased from zero at the time of diagnosis to 23.6% at the time of study visit. Most participants retired at a mean age of 43.6 years — and 95.7% of them cited MS progression as the reason for retirement. Among the student population, 90.9% reported absenteeism in the year before the study visit. During the same time period, 30.9% of employed participants were absent from work. Overall, 10.1% of all participants took sick leaves during the prior year. Being absent from work, and early retirement, impose several indirect costs in this study population, the researchers found. Sick leave due to MS resulted in a mean annual cost of €416.6 (US$473.59), while work absenteeism accounted for €763.4 (US$867.83) yearly. Early retirement due to MS added an additional mean annual cost burden of €5,810.1 (US$6,604.92). The annual costs per patient due to premature work disability or pension increased to €1,816.8 (US$2,065.34). Caregivers accompanied 72% of the patients for the study visit. The researchers noted that participants' spouses reportedly spent a minimum of more than 200 hours annually in providing care — more than a full-time job. A total 28.1% of participants required paid professional support for their daily activities, such as person to do housework and a physiotherapist. Patients also reported the use of assistive devices and adaptations. Crutch or walking stick use was reported by 10.6% of participants, while 8% had some home adaptation to help in their daily activities. Use of non-reimbursable devices was reported by 21.6%. The mean annual cost of informal caregiving, including activities by professional staff, was €1,328.7 (US$1,510.46). Use of assistive devices added an additional €736.6 (US$ 837.37) yearly. “MS is responsible for a substantial economic burden due to indirect and informal care costs, even in a population with low physical disability,” the researchers said. “Effective therapeutic interventions to improve the management of early symptoms as well as implementing workplace strategies focused on job retention may be essential to decrease the high economic burden of MS,” they concluded.

One year of a vegetable-rich diet — combined with exercise, neuromuscular stimulation, and stress reduction techniques — is effective in easing fatigue in people with progressive multiple sclerosis (MS). Researchers say the results may be linked to changes in blood fat levels, in particular cholesterol. This integrative…

People with pediatric-onset multiple sclerosis (POMS) have a greater decline in cognitive function, and are more likely to experience cognitive impairment in adulthood, than those whose disease began when they were adults, a study reports. The study, “Long-term Cognitive Outcomes in Patients With Pediatric-Onset vs Adult-Onset…

Deferiprone, a compound that lowers iron levels in the bloodstream by binding to iron molecules, can slow progression of a severe neurodegenerative disorder called pantothenate kinase-associated neurodegeneration (PKAN), a study reports. Because a toxic buildup of iron in the brain is also associated with multiple sclerosis and other neurological…

Simvastatin, a widely prescribed statin that works to lower cholesterol levels, may slow brain atrophy and disease progression in people with secondary progressive multiple sclerosis (SPMS) for reasons unrelated to changes in blood cholesterol, a new analysis of a Phase 2 clinical trial reports. These findings are in…

Higher exposure to Ocrevus (ocrelizumab) is associated with greater immune B-cell depletion in the blood, and lessened risk of disability progression in patients with relapsing multiple sclerosis (MS) and primary progressive disease (PPMS), according to new research. The study supporting that finding, “Pharmacokinetics, Pharmacodynamics and…

A newly developed scoring tool enables better identification of patients with relapsing-remitting multiple sclerosis (RRMS) as well as those transitioning or already diagnosed with secondary progressive MS (SPMS). The research about that finding, “Validation of the Scoring Algorithm for a Novel Integrative Secondary Progressive Multiple Sclerosis (SPMS) Screening Tool,”…

Cellular senescence — the process of aging at the cellular level — may play a role in the development of primary progressive multiple sclerosis (PPMS) by limiting the ability of myelin-producing cells (oligodendrocytes) to renew and mature. The study with that finding, “Cellular senescence in progenitor…

A new web portal called Talk2Me that detects early changes in language could help doctors diagnose or determine progression in neurodegenerative disorders like multiple sclerosis (MS), the scientists who created it suggest. The open platform portal, which gathers language data through an array of cognitive tasks performed…

A link between fat molecules called ceramides and worsening disease in overweight and obese people with multiple sclerosis appears to exist, a study reports, with its findings suggesting that ceramides prompt the growth of immune cells called monocytes, which in turn spurs disease progression. These results also strengthen the likelihood that lifestyle factors, like diet and weight, can act as disease modifiers, its researchers said. High body mass index has been linked to the risk of developing MS, but for reasons that aren't clear. One idea is that weight-induced differences in lipids (fat molecules) in the blood, because they are involved in several cellular signaling processes, may affect MS and its course in people with higher BMIs. To test this hypothesis, a team led by researchers at the Advanced Science Research Center (ASRC) at The Graduate Center and at the Icahn School of Medicine at Mount Sinai analyzed 54 patients with relapsing-remitting MS (MS), ages 18 to 60, and with normal or high BMIs (27 people in each group). Participants were followed for two years. BMI is a measure of body fat based on height and weight. A normal BMI is defined as one between 18.5 and 24.9, while a person is considered overweight with a BMI of 25–29.9, and obese it is 30 or higher. Researchers took blood samples, and looked for differences between the groups in terms of both immune cells and blood lipid profiles. They then validated their findings in a separate group of 91 RRMS patients. Patients with high BMIs tended to have more monocytes than those with normal BMIs. Monocytes can travel through the blood to tissues where they develop into macrophages, immune cells with various functions that are best known for "eating" invading bacteria. Monocytes can also travel to the brain and damage nerve fibers. Overweight and obese patients also had significantly higher levels of ceramides compared with normal-weight patients, and the researchers wondered if a link might exist between the two. Through a set of experiments in cells, they discovered that ceramides cause epigenetic changes in monocytes; that is, they alter the way their genomes are "read," so they alter gene activity. Specifically, ceramide-treated cells showed a type of epigenetic change called methylation — which generally turns genes "off" — in genes that normally help prevent cells from dividing. Conceptually, these genetic changes serve to unleash monocytes, leading them to grow more (proliferate) than they otherwise might. The researchers also found more methylation on the genomes of monocytes from high-BMI patients than those from low-BMI patients, and they noted that the overweight or obese patients also tended to have greater disease activity, worse disability progression, and more brain lesions on MRI (magnetic resonance imaging) scans on follow-up. Finally, the researchers tested a mouse model of MS, giving one group of mice a standard diet and another a high-fat diet. Mice fed the high-fat diet were found to have greater disease severity, more brain lesions, and more monocytes, confirming the findings seen in MS patients. "This study gives us a much-needed view into the environmental influences that can affect and change the behavior of cells in an individual's body," Kamilah Castro, the study's first author, said in a press release. "Our findings suggest that increased levels of saturated fat as a result of dietary habits are one likely cause of the epigenetic changes that advance MS, which gives us a starting point for a potential intervention." According to the team, the findings support the concept of nutri-epigenomics: that is, the ability of food to alter the way the genetic information is interpreted by each cell, and suggest that "weight management and dietary intervention" might affect MS prognosis. One limitation was the study's small size, its researchers noted. "While we consider our results … very exciting and mechanistic, we acknowledge that the potential consideration of ceramide levels as biomarkers for disease progression in MS would require validation ... using larger cohorts with a longitudinal and/or cross-sectional design," they concluded. "It will also be important to evaluate the effectiveness of dietary intervention (with an emphasis on the reduction of specific classes of saturated fats), as potential modulator of plasma ceramide levels and possibly of disease course in MS patients."

Treatment with oral ibudilast slows brain shrinkage in patients with primary progressive multiple sclerosis (PPMS), but not in those with secondary progressive MS (SPMS), according to results of a Phase 2b clinical trial. According to the findings, this could be partially due to faster disease progression in untreated…

T20K, Cyxone‘s lead compound for treating multiple sclerosis (MS), seems able to prevent or slow disease progression, according to data from preclinical studies. Based on these findings, the company is confident that T20K might become a prophylactic (preventive) medication for MS in the near future. T20K is a…

Two-year treatment with temelimab reduced brain atrophy, or shrinkage, preserved myelin, and reduced disease progression in patients with relapsing-remitting multiple sclerosis (RRMS), according to findings from an extension study of a Phase 2b clinical trial. Temelimab, previously known as GNbAC1, is a monoclonal antibody that neutralizes the MS-associated human…

The evaluation of disease progression in multiple sclerosis (MS) patients through magnetic resonance imaging (MRI) can be performed without the use of a contrast agent, new research has shown. These findings suggest that routine use of contrast-enhanced MRI is unnecessary for most follow-ups with MS patients, reducing both imaging…

MSCopilot, a software device designed for the self-assessment of multiple sclerosis (MS), distinguishes between patients and healthy controls, and potentially could be used in clinical practice for the monitoring of MS disability progression and patients’ response to treatment. Matthieu Lamy, from Ad Scientiam, the…

A method based on cerebrospinal fluid measurements and magnetic resonance imaging (MRI) can aid in stratifying patients with multiple sclerosis (MS) at the time of diagnosis, which may help identify a tailored therapeutic approach for each patient from early disease stages. The data was presented by Roberta Magliozzi, from…

As the protective molecular caps of our genetic information — called telomeres — become shorter in certain immune cells, the extent of multiple sclerosis (MS) disability progression increases, regardless of age, researchers at the University of California, San Francisco (UCSF) reported. The findings were presented at the annual…

The rate of spinal cord tissue loss is a strong indicator of conversion from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS), according to a finding presented at the fourth annual Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2019. The forum…