By Elinor Nauen
For a number of years, scientists have been exploring the link between inadequate vitamin D intake and an increased risk for a number of chronic diseases, including multiple sclerosis.
Low D = Higher risk of MS
“What has changed in our understanding regarding vitamin D is that we now have data showing that low levels of vitamin D in healthy young adults predict a higher risk of developing MS,” said Alberto Ascherio, M.D., DrPH, professor of Epidemiology and Nutrition, Harvard School of Public Health, and professor of Medicine, Harvard Medical School.
Dr. Ascherio was the lead researcher of a large study, published in the Journal of the American Medical Association, that found the risk of MS fell as blood levels of the vitamin rose. Current research hopes to determine if taking D supplements could be a factor in preventing MS altogether.
Most people with MS—indeed, most Americans—have insufficient levels of D, which is also necessary for bone health. “That’s a strong rationale to provide supplementation,” Dr. Ascherio noted. “And it’s never too late to begin, but it’s certainly better to start earlier. Adolescence, when the risk of MS is low but is about to increase sharply, would be a good time to intervene.”
Experts are also beginning to reconsider D’s use by people with MS, especially as some early evidence suggests D might reduce relapses. Whether D helps people who already have MS is “very difficult to address without a large controlled trial,” said Dr. Ascherio. “There’s a lot of hope but it’s still an open question.”
While waiting for answers…
While further research on the effects of D on the immune system in MS is in progress, avoiding deficiency is certainly wise. “I think it’s a good idea for most people with MS get their levels of vitamin D tested,” said Dr. Ascherio. “I’m not saying everyone should take supplements, but for several reasons, such as heat intolerance, people with MS often don’t get enough sunlight—the major source of D.” Other sources include fortified orange juice, cereals, dairy products, oily fish such as salmon and supplements. Discuss your particular circumstances with your health-care provider.
The FDA has approved the marketing of Ampyra™ (dalfampridine, formerly known as fampridine SR, from Acorda Therapeutics) for its ability to improve walking in people with any type of multiple sclerosis. This is the first therapy specifically approved to treat a symptom of MS, and it represents a big step forward for the many people who may benefit. For more information, see the Research Advocate’s column on page six or view a new National MS Society Webcast on Ampyra now available online as webcast/podcast from MS Learn Online. Acorda has established a phone line that individuals may call for information: 1-888-881-1918.
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Cladribine, an oral disease-modifying therapy for relapsing forms of MS, is also applying for marketing approval. A potent chemotherapy drug, Cladribine kills immune T cells and B cells, both of which are thought to be involved in immune attacks in MS.
These are just two of a number of experimental MS drugs that are soon to be making news. There are also the anti-inflammatories: BG00012 (or BG-12), Laquinimod and Teriflunomide.
Fingolimod (or FTY720), an immunosuppressant, keeps harmful immune cells out of the brain and spinal cord where they can cause the damage seen in MS.
All are taken as pills.
For even more information about the oral MS drugs—including clinical trials that are currently recruiting participants—visit nationalMSsociety.org/news and type the name of a drug into the search field.
The time from here to there
The era of the oral MS drugs is expected to begin this year. But that doesn’t mean that every drug being tested now will be available this year—or even next. And it’s always possible that a therapy, however promising, will be sent back to the drawing board.
Minocycline, an antibiotic in pill form, is currently being studied in a phase III clinical trial—the last step before submission to the FDA for approval—but the study won’t be completed until at least late 2015. And FDA approval could take as long as six months to a year after that.
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