Welcome to the Summer edition of Professional Connection. This e-Newsletter has been developed with you in mind. The Pacific South Coast Chapter Clinical Advisory Committee is proud to offer up-to-date and valuable information to our medical provider partners in 2011. This is your newsletter, so please send us your thoughts and suggestions and tell us what you would like to see more of in the coming months.
Tysabri Risk Stratification
Jack H. Florin, MD
MS Center at Fullerton Neurology
Risk of PML for patients on Tysabri has long been estimated as 1:1000 overall. Risk can now be stratified. To be at risk, patients must harbor the JC virus. The STRATIFY study has recently shown that 56% of MS patients are positive for the JCV antibody. 37/37 PML patients with serum available were JCV AB +, none negative.
45% of PML patients were previously treated with an immunosuppressive (IS), 20% not and the remainder unknown. Treatment before use of Tysabri with any IS confers a 4-fold higher risk of PML. Risk is greatest between 24-30 months of therapy and may fall thereafter. No patient has developed PML at less than 12 months.
Risks are as follows:
| if JCV- | if JCV+ and no IS | if JCV+ and IS |
| <2 yrs: 0.1/1000 = 1 in 10000 or less | <2 yrs: 0.35/1000 = 1 in 2850 | <2 yrs: 1.2/1000 = 1 in 833 |
| >2 yrs: same as <2 yrs | >2 yrs: 2.8/1000 = 1 in 357 | >2 yrs: 8.1/100 = 1 in 123 |
A commercial JCV antibody assay is not yet available. STRATIFY sites will test any MS patient (whether or not on Tysabri) and forward results to the patient’s neurologist. Look at the Stratify study.
Ref. Poster 0.3248, Sandrock et al, AAN, 2011.
Mark Your Calendars!
Psychosocial Intervention in MS: Strategies for Mental Health Professionals is a continuing education program for mental health providers who are interested in the field of MS. This program will be held Wednesday, August 17 from 8:30am-4:30pm in Santa Ana. Register today.
Save the Date!
The Annual Meeting for the Consortium of MS Centers is coming to San Diego.
View more information. Stay tuned for more details in future issues of the Professional Connection.
Local Scientists Published
Zuzana Hostomska, PhD
Volunteer Research Advocate
Two seminal papers were published recently by scientists in our area. The first is a report from the lab of Dr. Christopher Glass at UCSD on the discovery of a steroid hormone ADIOL, (5-androsten-3Β, 17Β -diol), a precursor of androgens and estrogens that modulates inflammation induced by microglia cells. This discovery may eventually lead to new treatments for patients with neurodegenerative conditions in which inflammation plays a pathogenic role.
The second paper that we would like to highlight is a report from the laboratory of Dr. Michael Demetriou at UCI on the interaction between an individual's genetics and his or her environment in MS development.
Also, we would like to make you aware of the upcoming California MS Research Forum that will be held in San Francisco on August 5 and 6, 2011. The highlights of this meeting will be brought to you in the next issue of Professional Connection. Learn more about the program.
Program Highlights
Did you know the National MS Society offers hundreds of programs and services each year to assist people living with MS in your community? Please tell your patients with MS to call on us and see how we can help them live their best life. If you would like more information on how we can help your patients living with MS, please contact us today to learn more.
| RESOURCES |
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National MS Society's Professional Resource Center houses the most comprehensive library of MS information in the world, and provides a varierty of information and consultation services.
Professional Toolkit |
Become a Medical Volunteer
Want to get out of the office for a day? Join us as medical support for our participants. Positions available along the route (the beautiful Southern California coast!) and at festival site locations. You can help at one or both of these events:
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Challenge Walk MS - September 23-25
This 3-day, 50-mile walk hosts 300 walkers from Carlsbad to San Diego. We need ten medical professionals on September 23 & 24, and five on September 25. Volunteer today. -
Bike MS Bay to Bay Tour - October 22 & 23
Voted "Southern California's Best Cycling Event" by the readers of Competitor magazine, over 2,500 cyclists pedal 15, 30, 100 or 150 miles over 1 or 2 days. We need ten medical professionals on Saturday, October 22 and six on Sunday, October 23. Volunteer today.
If you have any questions, contact Linda Ingram.