Joint Medical Meeting (CMSC/ACTRIMS) Focuses on Research Progress and Issues in MS Clinical Care - National Multiple Sclerosis Society

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Joint Medical Meeting (CMSC/ACTRIMS) Focuses on Research Progress and Issues in MS Clinical Care

June 20, 2013

Multiple sclerosis was the focus of the 27th Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), the 18th Annual Meeting of Americas Committee on Treatment and Research in Multiple Sclerosis (ACTRIMS) and the Fifth Cooperative Meeting of these two organizations. This joint meeting was held May 29 to June 1 in Orlando, FL, and was attended by 1,800 health professionals. Abstracts from both meetings are available online.

Here is a sample of some of the findings reported, among more than 200 presentations on research seeking to stop MS in its tracks, to restore function to those who have MS, and to end the disease forever. In most cases, studies presented are considered preliminary. Many of the results will be analyzed more thoroughly, and usually published in peer-reviewed scientific and medical journals. Confidence in a study’s findings grows when it is repeated by others, with similar results.

STOP

Bone marrow transplantation trial: Dr. Richard Nash (Colorado Blood Cancer Institute, Denver) and colleagues are following 24 people with highly active relapsing-remitting MS who were treated with bone marrow transplantation. (In this experimental treatment, people are given infusions of their own bone marrow, which is first extracted and treated, to rid the body of immune cells that drive the MS attack.) The two-year results were reported, showing that both relapses and disease activity observed on MRI scans were significantly reduced. There was significant loss of brain tissue volume at one year, which then stabilized. One person died from loss of neurologic function at 32 months. Adverse events also included one suicide attempt, excessive levels of uric acid and liver enzymes, and decreased potassium levels. Participants are being followed for a total of five years. Additional research, currently underway, is needed to weigh the risks and benefits of this experimental procedure for people with MS. (Abstract #P20, ACTRIMS)

Gender and disease: MS is more common in women, but men tend to get more severe disease. Sienmi Du and colleagues (University of California, Los Angeles) tested whether male and female sex chromosomes influence the response of the nervous system to injury. In female mice genetically engineered to express the male (XY) or female (XX) chromosome, XY mice experienced a more severe MS-like disease with more nerve tissue damage in the brain and spinal cord. Interestingly, immune responses did not differ. If confirmed in further studies, such findings may help to explain why MS progression occurs faster in men. (Abstract #2.2, ACTRIMS)

RESTORE: Rehabilitation

Stopping Falls in MS:

Because of mobility problems and other symptoms, people with MS are at significant risk for falls.
  • Debra Frankel (National MS Society) and colleagues reported that participants in the Free from Falls program developed by the Society improved in balance and walking, and the psychological impact of falls was reduced. Results were sustained six  months after the program, with improvements in confidence and decreases in fear of falling. (Abstract #SX12, CMSC)
  • Dr. Jacob Sosnoff (University of Illinois at Urbana-Champaign) found that fall risk decreased significantly and balance improved in 10 people who participated in a 12-week, home-based exercise program focusing on balance and lower limb muscle strength, compared with 12 controls who did not participate. Dr. Sosnoff has additional funding from the Society’s pilot program to continue studying how exercise can be used to prevent falls in people with MS. (Abstract#RH05, CMSC)
  • Drs. Lisa Vingara (Oregon Health and Science University, Portland) examined falls among 53 people with MS who took from zero to 19 medications. Those taking no medications had a 27% risk of falls, and the odds of a fall increased by 33% with each additional medication. Medications acting on the nervous system were significantly associated with increased fall risk, but not medications affecting the immune or cardiac system. Larger studies are needed to confirm how medications might affect fall risk, so that clinicians can consider this important aspect of MS management to help people maintain mobility. (Abstract #RH36, CMSC)
Video chatting improves exercise behavior:  Dr. Lara Pilutti and colleagues (University of Illinois at Urbana-Champaign) were funded by a Society grant to Dr. Robert Motl to examine whether video-chat sessions with a behavior change coach could improve the results of a 6-month physical activity program. The results show significant improvements in increasing physical activity – as well as reducing fatigue, depression and anxiety – among those participating in the internet-delivered program versus controls who were not in the program. (Abstract #SX23, CMSC)

Urinary symptoms – common and undertreated: Dr. Kristin Khalaf (University of Arizona, Phoenix) and colleagues conducted an online survey of more than 1,000 people with MS and found that 56% reported that urinary urgency or incontinence bothered them “quite a bit” or “a great deal.” Among these people, 46% had not discussed the symptoms with their health care providers and 35% had never been treated for them. Individuals can gain control of bladder issues in MS; read more. (Abstract #SX17, CMSC)Research - Restore button

RESTORE: Repair

Estrogen and repair: Dr. Stephen Nye (Endece, LLC) and colleagues reported on a study of the molecules that the sex hormone estrogen acts on in the brain and spinal cord. Estrogen is under study for its potential to treat MS. The investigators reported that the molecule NDC-1308 reduced cell death in the spinal cord of mice with MS-like disease and activated genes important in the development of myelin-making cells. The company is supporting preclinical research to develop NDC-1308 as a possible future treatment for repairing damage in MS. (Abstract #6.2, ACTRIMS)

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Characterizing disease in Hispanic/Latinos with MS: The Society funded Dr. Jacob McCauley and a team including Dr. Kottil Rammohan (University of Miami) to study 287 Hispanic/Latinos with MS and compare their experiences to 275 non-Hispanic whites. They reported that Hispanic/Latinos were more likely to experience symptoms of motor weakness, ataxia (problems with muscle control) and bladder problems. Hispanic/Latinos responded more favorably to interferon treatments. The team also looked at genetic differences, but only found differences in immune-related genes that are known to differ in these two populations. The Society’s Hispanic/Latino Advisory Council advises the Society on strategies and programs to overcome cultural barriers and make resources more available to this community. Read more about this council and about Hispanics/Latinos with MS.

Video chatting improves exercise behavior:  Dr. Lara Pilutti and colleagues (University of Illinois at Urbana-Champaign) were funded by a Society grant to Dr. Robert Motl to examine whether video-chat sessions with a behavior change coach could improve the results of a 6-month physical activity program. The results show significant improvements in increasing physical activity – as well as reducing fatigue, depression and anxiety – among those participating in the internet-delivered program versus controls who were not in the program. (Abstract #SX23, CMSC)

Urinary symptoms – common and undertreated: Dr. Kristin Khalaf (University of Arizona, Phoenix) and colleagues conducted an online survey of more than 1,000 people with MS and found that 56% reported that urinary urgency or incontinence bothered them “quite a bit” or “a great deal.” Among these people, 46% had not discussed the symptoms with their health care providers and 35% had never been treated for them. Individuals can gain control of bladder issues in MS; read more. (Abstract #SX17, CMSC)Research - Restore button

RESTORE: Repair

Estrogen and repair: Dr. Stephen Nye (Endece, LLC) and colleagues reported on a study of the molecules that the sex hormone estrogen acts on in the brain and spinal cord. Estrogen is under study for its potential to treat MS. The investigators reported that the molecule NDC-1308 reduced cell death in the spinal cord of mice with MS-like disease and activated genes important in the development of myelin-making cells. The company is supporting preclinical research to develop NDC-1308 as a possible future treatment for repairing damage in MS. (Abstract #6.2, ACTRIMS)

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Characterizing disease in Hispanic/Latinos with MS: The Society funded Dr. Jacob McCauley and a team including Dr. Kottil Rammohan (University of Miami) to study 287 Hispanic/Latinos with MS and compare their experiences to 275 non-Hispanic whites. They reported that Hispanic/Latinos were more likely to experience symptoms of motor weakness, ataxia (problems with muscle control) and bladder problems. Hispanic/Latinos responded more favorably to interferon treatments. The team also looked at genetic differences, but only found differences in immune-related genes that are known to differ in these two populations. The Society’s Hispanic/Latino Advisory Council advises the Society on strategies and programs to overcome cultural barriers and make resources more available to this community. Read more about this council and about Hispanics/Latinos with MS.

Examining virus genes in PP MS: Infectious agents have been investigated at various times as possible triggers of MS, but no single virus or bacterium has been proved to cause the disease. Dr. John Kriesel (University of Utah, Salt lake City) was previously funded by the Society to use novel genetics technology to determine the presence of viruses or bacteria that may not have been identified yet in people with MS. In the study reported here, he and colleague Dr. Benjamin Chan and others used a technique called “deep sequencing” to examine 14 people with primary progressive MS and 7 controls without MS. The activity of genes that instruct viruses known as retroviruses was significantly increased in people with PP MS. Further studies, about to get underway with Society funding, are necessary in larger numbers of people to determine the significance of these findings. (Abstract #P43, ACTRIMS)

The Sonya Slifka Longitudinal MS Study: A unique tool for studying MS: This study was established by the Society in 2000 to study demographic and disease characteristics, use and cost of health services, access to care, quality of life, and treatment, among 4,500 Americans with MS. Dr. Sarah Minden (Brigham and Women's Hospital, Boston, MA) reported that data collected from this study is being made available to qualified investigators, along with the services of the Slifka study team, which includes physicians, economists, statisticians, policy analysts, and programmers. Studies underway include: the direct and indirect costs of MS, impact of out of pocket costs, financial implications of informal caregiving, pregnancy, and mental health treatment. This database is a unique tool for gathering data to support advocacy, programming, and policymaking efforts. (Abstract #P37, ACTRIMS)

Read more about research to stop MS, restore function, and end MS forever.

About Multiple Sclerosis

Multiple sclerosis, an unpredictable, often disabling disease of the central nervous system, interrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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