Therapy and counseling

Invisible symptoms can create an isolating experience for people with MS. I recently was reminded of the power that lies in finding community and shared experience. Last month’s column discussed the chronic tightness and pain I experience. I then explored whether fascia may play a role in this…

Lots of columns and articles look at issues surrounding the topics of depression and mental health-related disorders. I have referenced them in various columns. What saddens me is the stigma surrounding depression that prevails in our society. There are many who struggle with depression and other forms of…

A deterioration in multiple sclerosis patients' handwriting aligns with drops in their movement, sensory and cognitive skills, a study reports. MS includes loss of hand dexterity and finger movement control. This affects a patient's capacity to manipulate objects and coordinate hand movement, skills needed in handwriting. Previous studies have shown that MS patients had less handwriting rhythm and control than healthy people. This time researchers decided to compare the handwriting movements of both MS patients and healthy volunteers. The research involved 19 MS patients and 22 healthy age-matched controls. The team asked participants to write a specific sentence on a digitizing tablet. They discovered that the way MS patients wrote was much different than those of the controls. The patients took a lot longer to write each word and to achieve spacing between words. This led to them taking a much longer time overall to write a sentence than healthy people. In addition, analysis of handwriting strokes showed that MS patients' writing wasn't as smooth as that of healthy people. Researchers also found a correlation between patients’ movement abilities and cognitive status on the one hand and their handwriting ability on the other. The team said it believed “these findings might be very useful when planning rehabilitative task-oriented interventions focused on handwriting abilities.” In fact, rehabilitation specialists should consider evaluating “both the motor movement and the cognitive status of PwMS [patients with MS] in order to tailor the intervention."

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with this column referencing terms starting with the letter “O.” Symptoms of MS Optic neuritis This is a common symptom of MS, though not everyone who experiences optic neuritis…

Australia has approved a shorter treatment regimen of Merck’s Mavenclad for relapsing-remitting multiple sclerosis. The Therapeutic Goods Administration authorized 20-day courses of the cladribine tablet form of the medication once a year for two years. The regimen reduces relapse rates and the progression of the disease for up to four years, Merck said. The new approval came after Merck submitted additional clinical trial findings on the therapy. Health Canada and the European Commission approved Mavenclad earlier this year. Merck continues to seek its regulatory approval in the United States and other countries. "Mavenclad will be a welcomed treatment option for patients with the relapsing-remitting form of MS,” Bill Carroll, clinical professor of neurology at the University of Western Australia and the Perron Institute, said in a press release. “As an oral therapy taken in two short courses over a two-year period, Mavenclad will be convenient for all eligible patients in Australia, including those who may not live close to their treating healthcare professional," added Carrol, a neurology consultant at the Sir Charles Gairdner Hospital as well as president-elect of the World Federation of Neurology. Mavenclad targets immune cells that trigger relapsing MS. Multiple sclerosis is an autoimmune disease, or one in which the immune system attacks healthy cells. Mavenclad inhibits harmful immune T- and B-cells without suppressing the entire immune system. Australia based its approval of the drug on the findings of a number of clinical trials, including the Phase 3 CLARITY, CLARITY EXTENSION and ORACLE-MS studies, the Phase 2 trial ONWARD study, and the long-term PREMIERE studies. The trials involved more than 2,700 RRMS patients, some of whom were followed more than 10 years. The trials showed that Mavenclad can significantly reduce relapse rates, disability progression and brain atrophy. Doctors recommended the therapy for patients who failed to respond to, or are unable to tolerate, other MS treatments. "We are pleased the Therapeutic Goods Administration has updated the product Information for Mavenclad in Australia to reflect additional clinical data," said Simon Sturge, chief operating officer of Merck's biopharma business. "Our next step is to work closely with the Australian government to bring this treatment advance to patients as quickly as possible."

U.S. nurses and physicians’ assistants prescribe antibody-based disease-modifying therapies to their multiple sclerosis patients more than neurologists do, a survey indicates. The trend has been for the doctors to stick with interferon therapies, the study said. Antibody-based disease-modifying therapies are also known as monoclonal antibodies. They are designed to harness the…

Anniversaries often invoke reflection about the beginning, the journey, and where we now find ourselves. With luck, lessons will have been learned from the invariably good and bad experiences that couple any passage of time. In November 2010, I sat, eyes firmly affixed, as my neurologist read my…

Europeans with relapsing multiple sclerosis (MS) and early primary progressive MS are one step closer to accessing Ocrevus, now that the European Medicines Agency has urged the European Union to approve the therapy. The positive opinion — announced in a press release issued Nov. 10 by the EMA’s Committee for Medicinal Products for Human Use — is an intermediary step required in the regulatory pathway to allow patient access to a new drug. The European Commission will now make a final decision on whether Ocrevus should be granted marketing authorization in all 28 EU member states. This decision will take the CHMP recommendation into consideration. If approved, Ocrevus will become the first disease-modifying medicine available throughout Europe for patients with PPMS. Once this happens, any decisions on price or insurance reimbursements will be the responsibility of each member state. Ocrevus won U.S. approval earlier this year. It was also recently approved in Switzerland for both relapsing MS and PPMS. Ocrevus is an anti-CD20 antibody developed by Genentech, a division of Roche. It blocks immune B-cells, preventing them from attacking nerve cells and their myelin protective sheath, as well as inhibiting other pro-inflammatory immune signals involved in MS. CHMP based its positive recommendation on data from three pivotal Phase 3 clinical trials: the OPERA I and II trials in relapsing MS patients, and the ORATORIO trial in PPMS patients. Results from the OPERA clinical studies demonstrated that treatment with Ocrevus for up to 96 weeks could reduce the annualized relapse rate by 46.4 percent compared with EMD Serono’s approved drug Rebif (interferon beta-1a) in relapsing MS patients. The ORATORIO trial showed that Ocrevus could reduce by 24 percent the risk of 12-week confirmed disability progression compared to placebo in PPMS patients. Data from the trial further supported the drug's therapeutic benefit in early-stage PPMS patients. Additional studies are warranted to better evaluate the therapeutic potential of Ocrevus for patients with more advanced stages of the disease. The most common treatment-associated adverse effects reported wee infusion-related reactions and infections.

Longevity Biotech has received a $316,384 grant from the National MS Society to see if LBT-3627, the nerve cell-protecting therapy it has tested in Parkinson’s, can work in multiple sclerosis as well. The company designed the therapy to protect and repair damaged nerve cells and restore balance to the out-of-whack immune response associated…

The CXCR7 receptor present on mature monocytes — a type of white blood cell — may be a therapeutic target to alleviate the inflammation seen in multiple sclerosis (MS) and similar disorders, a new study shows. The study, “Frontline Science: CXCR7 mediates CD14+CD16+ monocyte transmigration across the blood…

The National Multiple Sclerosis Society (NMSS) has officially announced its collaboration with Corrona on the launch of the Corrona Multiple Sclerosis Registry to compare the safety and effectiveness of approved therapies in multiple sclerosis (MS). Corrona, based in Cambridge, Massachusetts, conducts observational cohort studies, offering analytic expertise…

Radiologically isolated syndrome (RIS) is a rare and relatively recent condition in which people have multiple sclerosis (MS)-like brain and spinal cord lesions without showing disease activity. But since the establishment of the RIS diagnosis, researchers have not reached an agreement on whether these patients should receive MS disease-modifying therapies.

Using strategies to promote intellectual enrichment among patients with pediatric-onset multiple sclerosis could be essential to achieving better cognitive, social, and professional performances during adult life, according to researchers at the University of Florence in Italy. The finding was the subject of an oral presentation titled, “Cognitive reserve is…

I’ve had a cold for two weeks. So, I’ve been more tired than usual. Too tired, in fact, to write the column that was supposed to post last Tuesday. (I apologize to all of you who wait, with bated breath, for the appearance of the MS Wire each…

Disarm Therapeutics has completed the first round of financing to develop a compound that prevents axonal degeneration in patients with multiple sclerosis (MS) and other neurodegenerative conditions. The treatment approach is based on an earlier discovery at Washington University in St. Louis, showing that the enzyme SARM1…

Two researchers at the University of Tasmania’s Menzies Institute for Medical Research have received an innovative multiple sclerosis research fellowship that was created to drive basic scientific research into treatment development and the doctor's office. MS Research Australia and The Macquarie Group Foundation founded the three-year, $750,000 program. It is unique in that it will bring together basic science researchers and therapy-development researchers to try to convert laboratory research into disease solutions. The grant was awarded to Professor Bruce Taylor, a Menzies researcher who is also a neurologist at the Royal Hobart Hospital, and to Dr. Kaylene Young, a neuroscientist whose long career in laboratory research has focused on mechanisms that the brain uses to repair itself. Taylor’s achievements include identifying genetic mutations that may increase the risk of a person developing MS. The award will help him move these discoveries to the lab to determine how the mutations harm cells. Young discovered that a type of non-invasive brain stimulation can increase brain stem cells' ability to produce new cells that repair the nervous system. She plans to move the technology, known as transcranial magnetic stimulation, from the lab to therapy-development-related research.

The European Commission has approved Merck KGaA’s Mavenclad (cladribine tablets) to treat highly active relapsing forms of multiple sclerosis (MS). The Aug. 25 decision in Brussels marks the first approval of a highly efficient oral short course therapy for MS in Europe. Mavenclad has been shown to harness disease activity for…

Sometimes the nerve pain caused by MS reminds me of a pinball machine. With the slap of the paddles the ball surges, bouncing sporadically, bells ringing, lights flashing; then the ball quietly comes to a stop and all of the commotion is silenced until the next slap. The sharp…

Alkermes is funding a Phase 3 clinical trial evaluating the effects of its ALKS 8700 therapy on the gastrointestinal tracts of relapsing-remitting multiple sclerosis (RRMS) patients, compared to Tecfidera (dimethyl fumarate), according to a news release by the National Multiple Sclerosis Society. ALKS 8700, an orally administrated form of monomethyl fumarate, is still…

“The very beating of your heart has meaning and purpose.” This is a quote from Andy Andrews in “The Butterfly Effect.” I have referenced this quote on several occasions. It speaks volumes because it affirms that we are here on purpose, not by chance. I did an…

I stood at the front door of my house and could only shake my head as I watched the backhoe digging a deep trench in my yard. A sewer line malfunction created a mess in my basement and it turned out to be a broken clay pipe in…

As I write, I’m pain-free. This is important, but not for the obvious reason. I’m pain-free and can walk — or at least stumble — about as best as I’ve been able to manage of late. It’s not much, but I can be involved in family life and get…

The art of writing has been my refuge during some incredibly difficult times. Writing also serves as a vessel to express my joys, life lessons, and messages I wish to share with others. Writing is therapeutic. Expressing myself through prose and poetry allows me to connect with others. It…

Long-term Tysabri (natalizumab) treatment of relapsing multiple sclerosis (RMS) improves physical and mental health and leads to greater satisfaction with therapy, new research shows. The study, ”Long-term natalizumab treatment is associated with sustained improvements in quality of life in patients with multiple sclerosis,” appeared in the journal…

In case you missed them, here are some news stories that appeared in MS News Today that caught my eye over the past week: Q Therapeutics Approved to Start Trial of Cell Therapy Aiming to Restore Myelins Those of us with MS know that if something can…

Ocvevus (ocrelizumab) is off to a running start, Tecfidera (dimethyl fumarate) leads the pills and the four injectable multiple sclerosis drugs are being used by fewer MS patients. But Copaxone (glatiramer acetate injection) remains the leader of the pack of the disease-modifying therapies. Those are…

A group of experts recently concluded that clinical trials are the best way to explore whether cell-based therapies are viable options for treating multiple sclerosis. In a newly published article, MS researchers reviewed evidence on a range of cell therapies, including stem cell transplants and delivery or stimulation of various cell types. Clinical trials, the panel argued, would be the optimal way to examine which types of cells should be used, how they should be delivered, and the types and disease stages the treatments are suitable for. The article focused on four types of cell-based treatments: autologous stem cell transplants, mesenchymal and related stem cell transplants, use of drugs to manipulate stem cells in the body to boost their ability to repair, and transplants of oligodendrocyte progenitor cells to trigger new myelin production. Loss of the myelin that protects neurons is a hallmark of MS. Such treatments hold promise to attain what current disease-modifying therapies in MS have not: halting the disease without lifelong treatment that has potential side effects, and regenerating damaged tissue. In addition to reviewing the evidence surrounding cell-based treatments, the expert group focused on the availability of the treatment options outside of controlled trials. “Media attention has resulted in some cases of misrepresentation and exaggeration of therapeutic claims for cell-based therapies for multiple sclerosis and other diseases,” the team wrote. This has caused patients to seek the treatments — paying out-of-pocket — at unregulated clinics. The panel noted that several drugs in development, including opicinumab, are aimed at promoting remyelination. In addition, drugs that are already approved for other conditions might have remyelinating properties, and might be repurposed to treat MS. Although studies are ongoing, the panel noted that it is unclear if the drugs do promote remyelination. Despite ongoing research and — in some cases — clinical use of cell-based therapies for MS, these treatments should be considered experimental, the expert group concluded. They again underscored the importance of clinical trials in providing a controlled environment for patients wishing to have cell therapy, as well as a source of evidence for the feasibility of these approaches.

A cell therapy intended to boost myelin regeneration — Q-Cells by Q Therapeutics — has received a green light from the U.S. Food and Drug Administration to proceed with a clinical trial in patients with transverse myelitis (TM), a disease that like multiple sclerosis is characterized by myelin damage. FDA approval of the company’s Investigational New…

Back in the day, I always wanted to be a columnist. That day was so long ago it was before sunrise. In my youthful naivety, I never thought about generating an idea a week. I also never considered it would be about my travails with an illness. Still,…

One of the most dispiriting aspects of a chronic illness is that it traps you in your own world. Major events happen but these are filtered against the achievement of actually being able to get yourself to the bathroom. At the time of writing, we in the U.K.