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 achieve no evidence of disease progression (NEDA) in a greater proportion of African-descent patients, compared to treatment…
research
The rate of kidney deterioration as a result of bladder dysfunction due to multiple sclerosis (MS) is low, affecting only 3 percent of the patients, a single tertiary center study shows. However, kidney deterioration is a slow process and detected only after 60 months of follow-up, highlighting the need for…
A new U.S. law designed to update and expand data on Americans with multiple sclerosis (MS) and similar illnesses will significantly advance disease research, said the National Multiple Sclerosis Society (NMSS). The spending bill, signed into law Sept. 28 by President Trump, provides $5 million to the Centers for…
Genetic variants in the CPXM2, IGSF9B, and NLRP9 genes were found to potentially shape the disease course of multiple sclerosis (MS), and may be used as biomarkers to identify those with an aggressive or…
A small group of multiple sclerosis (MS) patients with aggressive disease, who were treated with hematopoietic stem cell transplant in a clinical trial, reported a drop in their fatigue levels that researchers suggested was likely due to lesser inflammation. The study, “Autologous hematopoietic stem cell transplantation improves…
Cannabidiol-derived Treatment for MS, EHP-101, Enters Phase 1 Safety Study, Emerald Health Says
Emerald Health Pharmaceuticals announced that it has begun enrolling healthy volunteers for a Phase 1 clinical trial evaluating the safety and tolerability of EHP-101, a potential cannabidiol treatment for multiple sclerosis (MS) and scleroderma. The randomized, double-blind, and placebo-controlled study (ACTRN12618001390279p) will investigate the safety and pharmacokinetics (how…
Multiple sclerosis patients using Rebif (interferon beta-1a) are not at an increased risk of a stroke, even if remaining on this therapy for more than two years, a study analyzing safety data from more than a dozen clinical trials and post-marketing surveillance shows. The…
A person’s social network can have an effect on their functional disability. This is what researchers discovered when they applied an online assessment tool they developed to people at risk of developing multiple sclerosis (MS). The tool, developed by researchers from Brigham and Women’s Hospital, Broad Institute in Boston,…
A 48-week treatment of relapsing multiple sclerosis (MS) with TG Therapeutics’ 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…
Smoking may increase multiple sclerosis (MS) disease activity, quicken disability progression, and speed the transition from relapsing to secondary progressive MS (SPMS) by as much as eight years, according to an MS Society review study. The review data shows that, although the U.K.’s National Institute for Health…
Often-overlooked MRI Signal May Aid in Early Diagnosis of MS, Other Brain Conditions, Study Suggests
Scientists have found that a usually-overlooked signal from MRI scans indicates brain regions of nerve cell death and may help in the understanding of brain development and the early diagnosis of brain disorders like multiple sclerosis (MS),…
Nyrada, a subsidiary company of Noxopharm, discovered a set of novel compounds that can cross the blood-brain barrier and blood-nerve barriers, and inhibit a master regulator of chronic inflammation in autoimmunity called IRAK4. The Australian company believes that these novel IRAK4 inhibitors may represent an alternative strategy to…
Four disease-modifying therapies (DMTs) for multiple sclerosis — Avonex, Rebif, Betaferon, and Copaxone — are cost-effective and reduce disease progression in MS patients, especially those with relapsing-remitting disease, according to 10-year, real-world results from U.K.’s MS Risk Sharing Scheme (RSS). But the long-term benefits observed wane over…
A recent study found that elder individuals with multiple sclerosis (MS) experience significantly less severe depressive symptoms and better quality of life than their younger counterparts. The research, “Subjective well-being differs with age in multiple sclerosis: A brief report,” was published in the journal Rehabilitation Psychology.
The Committee for Medicinal Products for Human Use (CHMP), an arm of the European Medicines Agency (EMA), has recommended that Gilenya (fingolimod) be approved to treat children and adolescents, ages 10 to 17, with relapsing-remitting multiple sclerosis (RRMS). If the CHMP opinion is accepted, Gilenya — marketed by…
Phase 3 Trial in the UK Soon to Test Statin, Simvastatin, in Slowing SPMS Progression I’ve taken a statin medication for years to keep my cholesterol in check. Now, a study is getting underway to see if one statin pill can also be used to treat MS. It’s particularly…
A molecule known as Sox10 enables brain cells called astrocytes to convert into myelin-forming oligodendrocytes, a new study in mice reports. The findings suggest an approach for myelin repair in patients with multiple sclerosis (MS) and similar disorders, its researchers said. The study, “In vivo conversion of…
Processing Speed Training May Help Improve Cognitive Function in MS Patients, Pilot Study Suggests
A brain training technique that helps boost processing speed was seen to significantly improve the cognitive capacity of multiple sclerosis (MS) patients, as well as their ability to perform everyday activities, a pilot study shows. The study, “A Pilot Study Examining Speed of Processing Training (SPT) to Improve…
Eighteen months after its entrance into the U.S. market, Genentech’s Ocrevus (ocrelizumab) has become the monoclonal antibody of choice to treat patients with multiple sclerosis (MS), according to a survey of nearly 100 neurologists across the U.S. Self-reported use of Ocrevus for the third quarter of 2018 surpassed…
Treatment with Rapacan (rapamycin) decreased the size and volume of brain lesions in patients with multiple sclerosis (MS), an Iranian study reports. The study, “Promising effect of rapamycin on multiple sclerosis,” was published in the journal Multiple Sclerosis and Related Disorders. Rapamycin, or sirolimus, is an immunosuppressive…
Lymphatic vessels, the “roads” that work to clear waste material from the brain, can also carry messages that direct immune system attacks against myelin, promoting the onset of multiple sclerosis (MS), new study shows. While the identity of these messages remains unknown, the findings suggest that blocking these signals could…
GeNeuro announced it has reacquired from Servier the worldwide rights to commercialize and develop the investigational humanized antibody GNbAC1 for the treatment of multiple sclerosis (MS). The decision came after Servier, a European company which, together with GeNeuro, developed the GNbAC1 program, declined to continue developing the therapy due to…
The synthesis and metabolism of fat molecules known as ceramides is linked to G-CSF signaling, which increases white blood cell infiltration into the central nervous system and results in inflammation in patients with multiple sclerosis (MS), a new study shows. The study titled, “The relevance of ceramides and their…
Progressive multiple sclerosis patients — with primary or secondary progressive disease — treated with high doses of oral ibudilast in a Phase 2 clinical trial showed a 48 percent slowing in the progression of brain atrophy, or shrinkage, relative to those given a placebo, study data show. What this…
The Multiple Sclerosis Society of Canada and the Multiple Sclerosis Scientific Research Foundation have awarded a $410,000 grant to fund research based on a new method for treating cognitive dysfunction in patients with progressive multiple sclerosis (MS). About 70% of progressive MS patients suffer from cognitive abnormalities that…
Remyelination therapies are on the horizon as an innovative multiple sclerosis (MS) treatment, according to my neurologist. These therapies have been on my radar the last few years, but to hear my neurologist say they could soon be a reality makes me hopeful of the possibilities. To offer a…
With a $5 million grant, the Multiple Sclerosis Society of Canada (MSSC) will support an 12-week international study to determine the effects of cognitive rehabilitation and aerobic exercise on those with progressive multiple sclerosis (MS), it was announced in a news release. The investigation is being touted as…
A large Phase 3 trial getting underway at sites across the U.K. will test the effectiveness of simvastatin, a widely used oral statin, in possibly treating secondary progressive multiple sclerosis (SPMS), the study’s sponsor, University College of London Hospitals (UCLH), announced. The study, the largest ever undertaken for SPMS…
Phagocytes, diverse cells of the innate immune system, are known to both promote and prevent inflammation, depending on whether they are programed to damage tissue or to repair it. A study in mouse model of multiple sclerosis (MS) now reports that this programming is not fixed, and that pro-inflammatory…
Treating primary progressive multiple sclerosis patients with Ocrevus (ocrelizumab) led to a three-fold increase in the proportion of those showing no evidence of disease progression and no signs of inflammatory disease activity over more than two years of treatment, results of a Phase 3 trial show, and support new measures that might better capture disability in PPMS patients. The research, “Evaluation of No Evidence of Progression or Active Disease (NEPAD) in Patients With Primary Progressive Multiple Sclerosis in the ORATORIO Trial,” was published in the journal Annals of Neurology. Measuring disease progression in clinical trials and clinical practice requires reliable and comprehensible measures. Although widely used, the Expanded Disability Status Scale (EDSS, range 0-10) cannot fully capture changes in walking speed and hand or arm function, which are key determinants of overall disability in progressive forms of MS. No evidence of progression (NEP) is a newer measure that reflects the absence of disability progression, including upper limb function and walking speed. Maintaining NEP status means stable disease with no worsening in EDSS, in walking ability (assessed by the Timed 25-Foot Walk (T25FW) test, or the time it takes to walk 25 feet as quickly and safely as possible), and in upper limb function (assessed by the 9-Hole Peg Test (9HPT), a test of arm and hand dexterity). Patients with PPMS have less frequent signs of disease activity, which include relapses and brain lesions (assessed though magnetic resonance imaging or MRI). So scientists proposed a new measure — called “no evidence of progression or active disease” (NEPAD) — to evaluate both NEP and clinical and MRI measures of active disease. The researchers believe that NEPAD may represent a more sensitive and comprehensive measure of disease control in PPMS patients. The randomized, double-blind ORATORIO Phase 3 trial (NCT01194570) analyzed the efficacy and safety of Ocrevus — developed by Genentech, part of the Roche group — in 732 PPMS patients (age range 18–55). Results showed that Ocrevus treatment delayed the relative risk of disability progression by 25% compared to placebo, while also reducing the volume of chronic brain lesions and total brain volume loss. As a result, Ocrevus became the first therapy approved by the U.S. Food and Drug Administration and the European Commission for both PPMS and relapsing MS. Now, researchers assessed Ocrevus’ effect in PPMS patients included in the Roche-funded ORATORIO study using as trial goals changes in NEP and NEPAD. These people received either 600 mg of Ocrevus or placebo by intravenous (IV) infusion every six months for a minimum of 120 weeks (about 2.3 years). The trial’s main goal was time to onset of clinical disability progression (CDP) sustained for at least 12 weeks. CDP was defined as a 1.0 point or greater increase in EDSS score from a baseline (study start) score of 5.5 or less, or a 0.5-point increase from a baseline score greater than 5.5. NEP status, analyzed in 230 placebo- and 461 Ocrevus-treated patients, was defined as no evidence of CDP for 12 weeks, no 20% or more change in hand/arm function as measured by the 9HPT for 12 weeks, and no 20% or more change in walking ability as measured by the T25FW test for 12 weeks. "The 20% cut-off for progression on the T25FW test and the 9HPT has previously been shown to be a clinically meaningful magnitude of disease progression," the study noted. In turn, NEPAD — assessed in 234 placebo- and 465 Ocrevus-treated patients — included NEP, no brain MRI-measured disease activity, and no relapses. Relapses were defined as new or worsening neurological symptoms attributable to MS lasting longer than 24 hours and preceded by neurological stability for a minimum of 30 days. Brain MRI scans were conducted at baseline, and weeks 24, 48, and 120; new or enlarging T2 lesions and/or T1 enhancing lesions were considered evidence of MRI disease activity (T1 MRI imaging offers information about current disease activity by highlighting areas of active inflammation, while a T2 MRI image provides information about disease burden or lesion load). Overall, the majority of the PPMS patients analyzed experienced clinical disease progression or evidence of disease activity. From baseline to week 120, Ocrevus-treated patients who achieved NEP (42.7% of 461 people) or NEPAD (29.9% of 465) — no disease activity or progression — were found to have lower T2 brain lesion volume and a lower EDSS score (lesser disability) compared to those with evidence of MS progression. They also had a slightly superior performance on the 9HPT and the T25FW test. Patients who reached NEPAD also showed fewer T1 lesions than patients with progressing or active disease. Compared to placebo treatment, the proportion of Ocrevus-treated PPMS patients maintaining NEP or NEPAD from baseline to week 120 was higher — for NEP, 42.7% versus 29.1% in the placebo group; for NEPAD, 29.9% versus 9.4% in the placebo group. These results showed that Ocrevus treatment increased the proportion of PPMS patients with NEPAD throughout the 120 weeks of the study by three-fold. “In conclusion, ocrelizumab (Ocrevus) increased the proportion of patients with PPMS with no evidence of progression and no clinical and subclinical disease activity compared with placebo,” the team wrote. “As such, NEPAD may represent a meaningful and comprehensive disease outcome in patients with PPMS.” However, data from ORATORIO's open-label extension and real-world data are needed to "determine whether NEPAD maintained throughout 120 weeks will translate into sustained NEPAD and enhanced protection against accrual of disability in patients with PPMS over the long term," the researchers concluded. Of note, five of the study’s 11 authors are employees and/or shareholders of Roche or Genentech.