More than 1700 MS healthcare providers and researchers gathered in person for the 36th Annual Meeting of the Consortium of MS Centers (CMSC) in National Harbor, MD, to share findings and learn the latest about diagnosing and treating MS, and to hear research updates. The meeting also focused on solutions that help people with MS to live their best lives.
Many studies showed the continued benefits of available therapies and longer-term safety information. Below are highlights of presentations largely focused on understanding the effects of MS on individuals and communities and managing symptoms to improve quality of life. Studies presented are considered preliminary until they are published in peer-reviewed journals.
Browse the meeting’s abstracts
. If an abstract is available, the link will be provided below.
Digitally treating MS fatigue:
Dr. Björn Meyer (Gaia Group), Dr. Stefan Gold (Charité Universitätsmedizin Berlin) and colleagues reported on a so-called “digital therapeutic” – an online program that employs cognitive behavioral therapy to treat fatigue. A previous trial
had shown that the program reduced fatigue significantly after 12 weeks. Now, the team strengthened these findings with additional data so it could become an accepted treatment. They showed that the reductions in fatigue remained significant at 24 weeks. The program, called Elevida (Gaia Group), is now a reimbursable therapy in Germany. The same team is studying
a similar program to treat depression in MS, with funding from the National MS Society. (Abstract IIS01
Building the Rehabilitation Workforce:
Suzanne Carron and Emily Reilly (National MS Society) and a team from the Society and their Healthcare Provider Councils (regional groups of healthcare providers) developed programs to educate rehabilitation professionals on the specific needs of people with MS. The Society secured continuing education credits for those who completed the program, including one which is available as an on-demand webinar series
. Topics include rehab assessment and intervention, exercise, and improving brain health. More than 150 people participated in the first presentations and were surveyed; 97% of those who responded said their knowledge of MS care improved, and 90% had an improved attitude toward caring for people with MS. (Abstract REH19
Stimulating improvement in MS symptoms:
Research is increasing on the benefits of brain stimulation for various MS symptoms. Juliana A.R. Telles (Brazilian Association of MS, São Paulo) and colleagues tested transcranial magnetic stimulation (TMS, a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain) in a series of small studies aimed at reducing fatigue and improving balance in combination with physical therapy (Abstract REH04
) and reducing depressive symptoms (Abstract MDC04
). All studies showed significant improvements in a majority of participants.
Functional electrical stimulation (FES) is a treatment that involves the application of a mild electrical charge to a muscle that helps it to move better. Lisa Donahue of Evolution Devices teamed up with researchers at the University of Washington, Seattle to test FES remotely in 9 people with MS. Participants received an EvoWalk (Evolution Devices) device by mail, which applies FES to the lower leg while walking. Participants also engaged in remote physical therapy for 9 weeks. Two participants discontinued treatment due to discomfort from the electrical stimulation. Walking improved significantly in those who completed the study. (REH16
One stimulation device was recently approved
by the FDA to treat people with MS, and others
are used to treat foot drop, so such studies are important to understanding the true benefits and moving this treatment strategy forward into standard care.
When is it safe to stop MS treatment?
There are no clear ways to determine when or if to discontinue disease-modifying therapies (DMTs) later in life. Dr. John Corboy (University of Colorado) and colleagues were co-funded by the Patient-Centered Outcomes Research Institute and the National MS Society to determine if and when DMTs could be safely discontinued. They focused the study on individuals who were most likely to be able to safely discontinue their DMTs based on previous studies and enrolled 356 people nationwide age 55 or older who had a stable course of MS for the past several years. About half were taken off their DMTs (mostly interferons and glatiramer acetate) and half continued on their current treatment. The results showed that new disease activity on MRI scans occurred in about 5% of those who continued treatment and in 12% of those who discontinued treatment. Relapses occurred in 1 person who continued treatment and in 3 who discontinued. These differences were not statistically significant – meaning that they do not prove or disprove that continuing treatment is more beneficial than discontinuing treatment. These data are the first to begin to address an important concern for people with MS. Further studies now underway should help to provide more solid answers about when and for whom it’s safe to stop therapy, including a study
in 250 people aged 50 and older who have inactive secondary progressive MS.
Getting help for spasticity:
Spasticity is one of the more common symptoms of MS but can be difficult to manage; it can be as mild as the feeling of tightness of muscles or may be so severe as to produce painful, uncontrollable leg spasms. Dr. Barry Hendin (Center for Neurology and Spine, Phoenix, AZ) surveyed 1177 people with MS to understand how they experience and describe these various symptoms and how they manage them. Most (91%) reported experiencing muscle spasms, using different terms to describe them. Spasticity was constant for 34% of respondents. Overall, 86% were taking one or more medication for spasticity; only 8% were “extremely satisfied” with this treatment. After developing symptoms, 78% initiated a discussion with their physicians, and 52% wished they had done it sooner. (Abstracts DXM02
) Get tips for understanding and managing spasticity
Small steps to better nutrition:
information on the importance of diet and nutrition
for people with MS is increasing, but these lifestyle changes can be hard to make. Dr. Meghan Beier (Johns Hopkins, Baltimore) talked about how to manage change when it comes to food. Make small moves –for example, “I will eat one more vegetable at dinner once a week” or “I will have one less soda each week.” Track the change and celebrate small wins. Adjust your environment, too, like putting healthy foods in reach (e.g., a bowl of fruit on the counter) or driving a different route to avoid a tempting food stop. And although you can be stubborn on the overall goal of eating well, try to be flexible on the steps you take. If it doesn’t work, think about why and redirect your efforts.