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New issue of MS in focus on disease courses in MS out soon!

source: MSIF

Issue 14 of our biannual magazine will look in detail at the disease courses of MS.

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Profile of the Month : January 2010

Jyoti Ronghe

Country: India
Age: 47
Diagnosis Year: 1998
Type of MS: Secondary progressive
Profession: Adoption consultant

"I had three general medical practitioners in my family, but none of them had heard of MS. My parents and my husband were sure that it would be curable. When we learnt that it was incurable they were shocked."

Deutsch English Español French Italiano Русский

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Genome-wide scan of 500,000 single-nucleotide polymorphisms among responders and nonresponders to interferon beta therapy in multiple sclerosis

Interferon beta (IFN) is an accepted treatment for relapsing-remitting MS. Not all people respond satisfactorily to IFN treatment and there are currently no tools to identify who this will affect. The authors of this study aimed to investigate whether a gene or combination of genes could determine the response to IFN in people with MS. They found that variants of some genes were associated with a good response to IFN. They also found that almost half of these genes were related to the metabolism of glutamate, a molecule which has previously been proven to have important roles in the central nervous system.

authors: Comabella M, Craig DW, Morcillo-Suárez C, Río J, Navarro A, Fernández M, Martin R, Montalban X

source: Arch Neurol. 2009 Aug;66(8):972-8

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Difference in disease burden and activity in pediatric patients on brain magnetic resonance imaging at time of multiple sclerosis onset vs adults

Because the majority of MS cases start in adulthood, clinical and MRI characteristics of MS in children are less well known than in adults. The authors compared MRI features of two groups of people, one with paediatric-onset MS and one with adult-onset MS. They found that the appearance of new lesions at the time of onset of MS was faster in children than in adults. Moreover, children had more lesions in the cerebellum and brainstem than adults. In previous studies carried out with adults, the features observed more frequently in children than in adults have been previously associated with a worse prognosis.

authors: Waubant E, Chabas D, Okuda DT, Glenn O, Mowry E, Henry RG, Strober JB, Soares B, Wintermark M, Pelletier D

source: Arch Neurol. 2009 Aug;66(8):967-71

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Serial combination therapy: is immune modulation in multiple sclerosis enhanced by initial immune suppression?

MS is an autoimmune disease of unknown cause with a very complex pathogenesis. The aim of MS treatments is to modulate rather than suppress the immune system.

Glatiramer acetate (GA) is an accepted immunomodulatory treatment for MS. In addition to its most commonly known mechanism of action, which consists of blocking the interaction between T-cells and myelin, some other mechanisms of action have been proposed. In people who receive GA, the assessment of a specific property of their T-cells can be used to monitor its beneficial therapeutic effects.

Furthermore, other treatments with immunosuppressant properties, such as mitoxantrone, have been also proven to be effective in MS. It has been demonstrated that a short period of treatment of mitoxantrone before treatment with GA improves the clinical response to GA.

The authors of this study have investigated the impact of mitoxantrone when given immediately before the treatment with GA on this specific property of the T-cells which had been previously associated with the therapeutic effects of GA. However, they found that the treatment with mitoxantrone did not modify this specific property of the T-cells. These results highlight the complexity of the mechanism of action of GA.

authors: Bar-Or A, Oger J, Gibbs E, Niino M, Aziz T, Renoux C, Alatab S, Shi F, Campagnolo D, Jalili F, Rhodes S, Yamashita T, Fan B, Freedman M, Panitch H, Arnold D, Vollmer T.

source: Mult Scler. 2009 Aug;15(8):959-64

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Magnetic resonance evidence of cortical onset of multiple sclerosis

MS is characterised by the presence of lesions in the white matter of the brain and the spinal cord. These lesions can be observed by conventional MRI techniques and are required for the diagnosis of MS. However, at the time of the onset of MS symptoms the MRI scan in some people is considered normal, without any lesion in the white matter. When this happens, the diagnosis of MS can be delayed. Although MS is a disease traditionally considered as predominantly affecting the white matter, the involvement of the grey matter has been shown to be important and related to clinical progression. The authors studied four people with symptoms suggestive of MS, who had normal MRI results, using a new MRI technique, double inversion recovery (DIR), They found that, despite having an apparently normal MRI result, all four people had lesions located in the cerebral cortex, which were shown by the DIR technique. From a pathological and diagnostic perspective, these findings may be very important.

authors: Calabrese M, Gallo P

source: Mult Scler. 2009 Aug;15(8):933-41

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Cognitive decline in multiple sclerosis: impact of topographic lesion distribution on differential cognitive deficit patterns

Some people with MS can develop some degree of cognitive impairment. Although brain volume loss, which can occur in people with MS, and the lesion load are associated with cognitive dysfunction, the exact mechanisms that determine this cognitive decline are not yet fully understood. In this article the authors have shown that the brain volume loss in deeper regions of the brain seems to play a more important role in determining cognitive impairment in people with MS than the total lesion load.

authors: Tiemann L, Penner I, Haupts M, Schlegel U, Calabrese P

source: Mult Scler. 2009 Aug 10

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Novartis secures FDA approval for Extavia

source: UK MS Society

Swiss-based drug maker Novartis has secured approval from American drug watchdog the Food and Drug Administration (FDA) to sell its Extavia MS treatement, its version of Bayer AG’s Betaseron (known as Betaferon in Europe).

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Study funded by the US National MS Society points to need for respite and mental health support for family caregivers

source: US National MS Society

A US study focusing on family members of people with MS with moderate to severe physical disabilities highlights the unique demographics of this population and their need for support.

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Sponsor reports positive results of clinical trial of Zenvia™ for pseudobulbar affect (uncontrollable laughing and/or crying)

source: US National MS Society

An oral drug designed to treat uncontrollable laughing and/or crying (also called pseudobulbar affect), a troubling symptom experienced by some people with MS and other neurological disorders, has passed another hurdle by showing positive results in a Phase III trial.

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MS-like disease in mice suppressed by fusing two immune proteins

source: US National MS Society

Researchers from Canada report that mice with an MS-like disease recovered, and the immune attack driving the disease was suppressed, when the team administered "GIFT15" – a compound formed by fusing two immune proteins.

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