EDSS

A new statistical method could help to more accurately capture changes in disability severity for people with multiple sclerosis (MS) and monitor the impact of MS treatments. “With the use of this new statistical methodology, it is possible to estimate the time to improvement as well as the…

A data-driven algorithm may be useful for defining the sometimes unclear transition from relapsing-remitting (RRMS) to secondary progressive (SPMS) forms of multiple sclerosis, a study found. The study, “Towards a validated definition of the clinical transition to secondary progressive multiple sclerosis: A study from the Italian MS Register,”…

COVID-19 does not seem to be linked to increased disability worsening or more relapses in the long term for people with relapsing-remitting multiple sclerosis (RRMS), an Iranian study suggests. The study was relatively small, the researchers noted, indicating that more research is needed in the future to determine the…

Eight weeks of hormone therapy was tolerable, and its use may ease the hot flashes and greater disease-related disability this life transition can cause in menopausal women with multiple sclerosis (MS), according to results of a small Phase 1b/2a trial of Duavee, an approved therapy. Public concerns over the safety of…

Low vitamin D levels in the bloodstream are associated with slower information processing speeds in people with early-stage multiple sclerosis (MS), a study suggests. “Our data support the hypothesis that vitamin D is involved in cognition in MS,” its researchers concluded. The study, “Serum Vitamin D as…

Editor’s note: The Multiple Sclerosis News Today team is providing in-depth coverage of the virtual 37th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Oct. 13–15. Go here to see the latest stories from the…

High-dose biotin aided walking speed in people with progressive multiple sclerosis after 12 to 15 months as an add-on treatment, an analysis of placebo-controlled clinical trials shows. However, the therapy failed to improve other measures of disability, and was associated with inaccurate lab test results caused by high levels…

Long-term disability outcomes tend to be better in people with relapsing-remitting multiple sclerosis (RRMS) who are treated early on with highly effective therapies, a study based on patient registry data indicates. The study, “Long-term disability trajectories in relapsing multiple sclerosis patients treated with early intensive or…

My left hand was numb and weak when I was first diagnosed with multiple sclerosis. For years after that, symptoms above my waist seemed just as prevalent as those below it. Yet, there were no tests being used that measured my waist-up disability level — nothing equivalent to the…

Treatment with Tysabri (natalizumab) can lessen disability in people with relapsing-remitting multiple sclerosis (RRMS), a large and real-world study found, supporting “confirmed disability improvement” reported in a pivotal clinical trial. Nearly one-quarter of the 5, 384 patients enrolled, particularly those new to treatment, experienced a decrease of at least one…

Women with multiple sclerosis (MS), and people who stay in a relapsing stage or use disease-modifying therapies (DMTs) for longer periods are less likely to transition to secondary progressive multiple sclerosis (SPMS) than others, according to a study based on the Italian MS registry. But patients whose…

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…

Autologous hematopoietic stem cell transplantation, also known as aHSCT, has been shown to be safe and highly effective to treat patients with "aggressive" multiple sclerosis. Tested in 19 patients, transplantation of stem cells was found to induce clinically meaningful improvements in disability. These findings were shared at the 2018 Annual Meeting of the American Academy of Neurology (AAN) in Los Angeles, California. aHSCT uses a patient’s own healthy bone marrow stem cells, in combination with a much less aggressive chemotherapy and/or radiation regimen, to prepare the patient for the transplant. Previous studies have suggested that aHSCT is an effective strategy to treat patients with highly active relapsing-remitting MS (RRMS) who do not respond to available disease-modifying therapies (DMTs), and international guidelines advocate for its use in patients with "aggressive" MS. To further demonstrate the potential of aHSCT as a treatment for "aggressive" MS, a research team evaluated its safety and effectiveness in MS patients who had not been treated previously with DMTs. A total of 19 patients were treated across several clinical centers: seven patients were from Sheffield, U.K., seven from Uppsala, Sweden, four from Ottawa, Canada, and one patient was from Florence, Italy. All patients received aHSCT between May 2004 and May 2017. In addition to aHSCT, patients were treated with BEAM (carmustine, etoposide, cytarabine, melphalan) chemotherapy plus antithymocyte globulin (ATG) to reduce transplant rejection, or with Cytoxan (cyclophosphamide) with ATG, or the triple combination of Cytoxan, ATG, plus busulfan as conditioning regimens. Patients had a median age of 33 years at diagnosis and received the aHSCT by a median time of nine years after symptom onset. They had a median disability score of 6.5 before the treatment, as determined by the Expanded Disability Status Scale (EDSS). After a median follow-up period of 30 months, patients had a median EDSS score of 2.0, which represented a median improvement of 2 points (the higher the score, the worse the patient's disability level). None of the patients had clinical relapse following the transplant of stem cells. Only three patients developed new brain lesions detectable by magnetic resonance imaging (MRI) at the first six-month follow-up evaluation, but no additional new lesions were detected in the following scans. The adverse effects reported during the study were comparable to those previously observed in similar treatments. No deaths related to the treatment were reported. Based on these preliminary results, the researchers concluded that aHSCT is “safe and highly effective in inducing rapid and sustain remission” in highly active MS, and "was associated with a significant improvement of [patient’s] level of disability.” “aHSCT should be considered as first line therapy in patients with ‘aggressive’ MS,” the team concluded. Another study presented at the AAN 2018 meeting further supports these findings, demonstrating the superior effectiveness of aHSCT over conventional DMTs for RRMS.

A stem cell treatment improved the neurological symptoms of three-fourths of the multiple sclerosis patients in a Phase 1 clinical trial, New York researchers reported. The results prompted the team at the Tisch MS Research Center of New York to start a Phase 2 trial to further assess the therapy’s…

Deep grey matter volume loss in the brain drives multiple sclerosis (MS) progression and disability, and is particularly evident in people with progressive forms of the disease, a retrospective multi-center study suggests. The study “Deep grey matter volume loss drives disability worsening in multiple sclerosis” was published in…

Relapsing-remitting multiple sclerosis (RRMS) patients accurately report the use of the RebiSmart autoinjector to their neurologists, a questionnaire-based study has found. The Phase 4 noninterventional CORE study also suggests that being knowledgeable about RebiSmart is a key factor in improving usage in younger patients and those with lower disability levels.

Costs associated with multiple sclerosis increase as the disease worsens, according to a study of more than 16,000 patients in 16 European countries. The study, “New insights into the burden and costs of multiple sclerosis in Europe,” was published in the Multiple Sclerosis Journal. Researchers obtained their information from patient self-reporting. Patients used the Kurtzke's Expanded Disability Status Scale (EDSS) to assess the severity of their disease. They also reported on their quality of life and their resource use. Patients were divided into three categories. Those with a score between 0 and 3 on the EDSS scale were deemed to have a mild disease. The disease of those with scores of 4 to 6.5 was considered moderate. And the disease of those with scores of 7 to 9 was classified as severe. Patients assessed their health-related quality of life with the EuroQol Five Dimensions questionnaire. The average age of the 16,808 participants was 51 and a half years old. The work capacity of MS patients dropped from 82 percent of a healthy person's to 8 percent as the severity of the disease increased, researchers said. Patients' quality of life scores were about the same as those seen in the general population when they had a mild disease. But they plunged to less than zero when their disease became severe. The mean annual cost of having a mild form of MS was 22,800 euros, or around $26,300, researchers reported. The cost of having a moderate disease was 37,100 euros, or about $42,800. And the cost of a severe disease was 57,500 euros, or $66,340. Healthcare accounted for 68 percent of total costs with a mild disease, 47 percent with a moderate disease, and 26 percent for a severe disease. "Costs are dependent on the availability, use and price of services and on disease severity," the researchers wrote. "Costs were related to disease severity" in all countries "and were dominated by production losses, non-healthcare costs and DMTs," or disease-modifying therapies. Those therapies may be a key reason why the highest percentage of healthcare costs occurred in patients with a mild disease, researchers said. Doctors prescribe a lot of DMTs to this group. Other factors related to the high percentage were that many patients with mild diseases are still able to work -- meaning they incur fewer production-loss costs -- and this group requires fewer community services. As MS becomes more severe, patients' production losses rise, and they use more community services. "The intensity of healthcare service use varied widely across the countries," researchers wrote. "This reflects differences in healthcare organization, medical traditions, ease of access and – most importantly – availability of given services." Researchers also assessed patients' levels of fatigue and cognitive difficulties. Ninety-five percent reported fatigue, and 71 percent cognitive difficulties. Fatigue and cognitive difficulties had significant impacts on quality of life scores, researchers said.

People with late-onset multiple sclerosis (MS) tend to more rapidly rise in disability scores than younger patients with early onset MS, according to study in MS patients in Kuwait that compared their scores during follow-up consultations. Typically, the first symptoms of  multiple sclerosis occur between the ages of 18 and 40, with…

ECTRIMS 2016 (European Committee for Treatment and Research in MS) produced lots of stories with exciting headlines about advances in MS research — and hopefully you read many of them here at MS News Today. As I went through the various presentation titles, there were a couple that jumped…

Long-term observations together with mathematical modeling present a way of predicting the likely disability trajectory of multiple sclerosis (MS) patients. The approach was outlined in a presentation, titled “Long-term disability trajectories in primary progressive MS patients – a latent class growth analysis,” given at the 32nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held in London…

A high fraction of patients with multiple sclerosis (MS) who underwent a transplant with their own bone marrow stem cells after immunosupression therapy, show no signs of disease activity after treatment, according to a new study. The results were presented in a talk, “Clinical experience in aggressive multiple sclerosis treatment with…

MicroRNAs present in the blood show promise as potential biomarkers of multiple sclerosis (MS), a new study suggests. The study, titled “Comprehensive Evaluation Of Serum MicroRNAs As Biomarkers In Multiple Sclerosis,” was published by Keren Regev, MD, and colleagues in the journal Neurology. Human DNA contains…

An entry in the comments section of Multiple Sclerosis News Today caught my attention a couple of weeks ago, and peaked my interest. It was a personal tale of one woman’s journey from being paralyzed and told that her condition was “between you and God” to being able to walk again, thanks to HSCT.

High blood pressure may be linked to greater overall disability in people with multiple sclerosis (MS), although the rate at which disability progresses might be slower than in patients without hypertension, a retrospective study concludes. The research, involving a large number of MS patients, helps to clarify a rather confusing range of views on how…

New long-term research indicates that having multiple children does not lessen or otherwise impact disability in women with multiple sclerosis (MS). The study, titled “Offspring Number Does Not Influence Reaching the Disability’s Milestones in Multiple Sclerosis: A Seven-Year Follow-Up Study,“ was published in The International Journal…

A new study recently published in the journal BMC Neurology revealed that natalizumab (TYSABRI) is a safe and effective medication for pediatric cases of multiple sclerosis (MS). The study is entitled “Natalizumab in the pediatric MS population: results of the Italian registry” and was…

Results from the BENEFIT11 trial indicate that early treatment with IFNB-1b leads to improvements in cognition and fatigue in the long-term, as well as sustained employment and favorable magnetic resonance imaging (MRI) outcomes, measured at the 11-year mark. Supported by Bayer HealthCare Pharmaceuticals, the study, titled “Long-term Impact of Early MS Treatment with…