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Disclaimer: 'MS Views and News' DOES NOT endorse any products or services found on this blog. It is up to you to seek advice from your healthcare provider. The intent of this blog is to provide information on various medical conditions, medications, treatments, and procedures for your personal knowledge and to keep you informed of current health-related issues. It is not intended to be complete or exhaustive, nor is it a substitute for the advice of your physician. Should you or your family members have any specific medical problem, seek medical care promptly.

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CHAMPIONS TACKLING MS - AWARDS Dinner, Honoring Aaron Boster, MD and Jon e. Glaser, DDS - now open for registration. Visit www.events.msvn.org

Saturday, September 27, 2014

Researchers Get Funding to Find Treatment for Untreatable MS

The ABC affiliate in Boston, WCVB, and MS Discovery Forum report on the International Progressive MS Alliance grant awards and what they could mean to people living with progressive MS.

Click: 

Researchers Get Funding to Find Treatment for Untreatable MS






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Find an MS Care Provider

Partners in MS Care

The National MS Society’s Partners in MS Care program involves healthcare professionals in the areas of neurology, mental health and rehabilitation. Healthcare professionals recognized as Partners in MS Care:
  • demonstrate knowledge and experience in MS care,
  • have a special interest in treating people living with MS, and
  • work closely with the Society
 Please contact an MS Navigator for additional names of healthcare providers.

Providers for U.S. veterans with MS

The Veterans Administration (VA) provides healthcare services to veterans with MS through a system of approximately 70 regional MS specialty clinics throughout the US. You can receive MS care, whether your MS status is considered service-connected or not. Find a VA clinic or MS Center of Excellence below.
The Department of Veteran Affairs runs a monthly support and education conference call for care partners of veterans with MS. In addition to time for networking and sharing of experiences, educational topics and resources are discussed. Learn about this and other care partner resources on the VA website.
The above information is provided by The National Multiple Sclerosis Society






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Laquinimod in MS: Latest Safety Data, is 'Reassuring'

September 26, 2014

BOSTON — The latest data from long-term follow-up of patients receiving laquinimod (Nerventra, Teva Pharmaceutical Industries Ltd/Active Biotech) in clinical trials have shown "reassuring" results in terms of adverse effects, it has been reported.
Presenting the latest results from a pooled analysis of laquinimod clinical trials with patients receiving the drug for up to 4 years, Giancarlo Comi, MD, from San Raffaele University, Milan, Italy, noted that there have been no new adverse effects seen and no signal of any type of cancer, and the adverse event rate in general appears to be less in the extension phase than in the core studies.
Dr. Comi presented the update here at MSBoston 2014, the 2014 Joint Americas and European Committees for Treatment and Research in Multiple Sclerosis (ACTRIMS/ECTRIMS) meeting.

Cancer Concerns in Animal Studies
The drug is not yet available, having been turned down a second time by the European Medicines Agency's Committee for Medicinal Products for Human Use earlier this year because of concerns about cancer and possible teratogenic effects in animal studies of long-term exposure to laquinimod, as well as uncertain efficacy data from 2 phase 3 clinical trials.
Final results of the Assessment of Oral Laquinimod in Preventing Progression in Multiple Sclerosis (ALLEGRO) trial, published in the March 15 issue of the New England Journal of Medicine, showed that treatment with laquinimod reduced annualized relapse rates and delayed disability progression compared with placebo. However, results from a second pivotal phase 3 trial, BRAVO (Laquinimod Double Blind Placebo Controlled Study in RRMS Patients With a Rater Blinded Reference Arm of Interferon β-1a [Avonex®]), comparing laquinimod with interferon-beta-1a (Avonex, Biogen Idec), missed the primary endpoint of reducing annualized relapse rates, although the reduction seen with laquinimod was significant after researchers adjusted for an imbalance between groups in the volume of T2 disease and the number of gadolinium-enhancing lesions on magnetic resonance imaging.
Both trials, however, showed a reduction in disability that was unexpected, given the effect seen on relapse rates, raising the possibility that the agent might be affecting disability through some novel mechanism. There was also a reduction in brain atrophy in line with the effect on disability, which was another novel finding with this agent.
This larger-than-expected effect on disability has stimulated continued interest in this agent. A third phase 3 trial, CONCERTO (The Efficacy and Safety and Tolerability of Laquinimod in Subjects With Relapsing Remitting Multiple Sclerosis [RRMS]), is now underway.
Meanwhile, the current presentation focused on a pooled analysis of the 2 phase 3 trials (ALLEGRO and BRAVO), with additional safety data from a phase 2 study.
Cochair of the session at which the new data were presented, Tanuja Chitnis, MD, from Brigham and Women's Hospital, Boston, commented to Medscape Medical News: "In general, the regulatory authorities have been looking for more data on longer-term tolerability with laquinimod. I thought these data from the extension arms of the major studies were reassuring on that."
Good Option for Combination Therapy?

Dr. Chitnis noted that laquinimod had shown a different profile than most other multiple sclerosis (MS) drugs, in that it has a modest effect on relapse rate, but apparently a more robust effect on disability progression and brain atrophy measures than one may expect. "This raises the question of using it in combination with other therapies," she added.



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Balance Impairment in Multiple Sclerosis Involves Multiple Systems

September 26, 2014

FRIDAY, Sept. 26, 2014 (HealthDay News) -- Balance impairment in multiple sclerosis (MS) involves constraints across multiple systems and consequently necessitates multimodal treatment, according to a study published in the September issue of the Journal of Clinical Outcomes Management.

Susan L. Kasser, PhD, and Jesse V. Jacobs, PhD, from the University of Vermont in Burlington, conducted a systematic literature review to examine the mechanisms and treatment options associated with balance impairment in patients with MS.

The researchers found that balance deficits are common in MS and result from constraints across multiple systems of postural control. Increased fall risk, decreased physical activity, additional comorbidities, and reduced quality of life were found to result from poor balance. For individuals with MS who experience balance and mobility problems, a variety of exercise options are available. Targeted therapies such as vestibular rehabilitation and weighted torso training as well as general exercise and balance training prescriptions are potential physical interventions.

"Given that postural impairments result from a diverse set of deficits in different underlying control systems, therapeutic intervention should be multimodal," the authors write. "Exercise prescription should address all affected contexts of postural control, including sensory and motor strategy training during postural transitions as well as induced postural perturbations, strength development, and gait activity."






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Thursday, September 25, 2014

LIVE WEBINAR “Everything You Wanted to Know about MS, BUT FORGOT to Ask”

Available to all, anywhere, as long as you have Internet Access


REGISTER to attend this free webcast
Q&A Session (Questions/Answers) - as detailed below

Submit questions in advance OR send your questions during the presentation so that your question is asked LIVE for all Globally watching this presentation.

“Everything You Wanted to Know about MS,
  BUT FORGOT to Ask”  
                   
WATCH this ‘Q&A’ (only) Program - to ask your questions about Multiple Sclerosis
  Submit YOUR MS Questions on anything to do with MS including:
Treatment Options, MS Relapse, Stem Cell, the many physical seen symptoms
Ask about anything with Primary and Invisible Symptoms and how to treat
Ask questions pertaining to Fatigue, Bladder, Pain, Vision, the Family, and so much more,,,
Questions in Spanish will also be answered

Ask Your Questions (in English or Spanish) to Our Panel of MS Professionals including:
Neurologist Arnaldo Isa, MD; Patricia Pagnotta, ARNP and 
Psychologist Justin Koenitzer, PsyD

Date: Saturday – November 22, 2014
11:15am – Program Begins
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RSVP for this webcast by clicking this link

Send your Questions via email: questions@msvn.org



Sponsored by:
Mallinckordt-Questcor, Acorda, Biogen-Idec, Genzyme and Teva

This program is Hosted by: "MS Views and News" (MSVN), a 501©(3) Not-For-Profit organization

09.17.14

The Science of MS Management: Update on Progressive Forms of Multiple Sclerosis


The Science of MS Management: Update on Progressive Forms of Multiple Sclerosis
Corey C. Ford, MD, PhD; Emmannuelle Waubant, MD, PhD
CME/CE Released: 12/31/2013; Valid for credit through 12/31/2014
Faculty and Disclosures
Corey C. Ford, MD, PhD
Dr. Ford has disclosed the following financial relationships:
Sources of Funding for Research: Biogen Idec, Elan, Genentech, Genzyme, Janssen, Novartis, Ono Pharmaceutical, Sanofi Aventis, Serono, and Teva CNS.
Consulting Agreements: Biogen Idec, Novartis, and Teva CNS.

Emmanuelle Waubant, MD, PhD
Dr. Waubant has disclosed the following financial relationships:
Consulting Agreements: Genentech, Novartis, Roche, Sanofi Aventis/Genzyme. 

ReviewerLaurie Scudder, DNP, NP
Laurie Scudder has disclosed no relevant financial relationships.

Planners and Managers
The following planners and managers have disclosed no relevant financial relationships: Joseph J. D'Onofrio, Frank Marino, Nancy Monson, Katherine Wandersee.
Target Audience
This publication is targeted to neurologists who have an interest in treating multiple sclerosis (MS).
Learning Objectives
Upon completion of this educational activity, the participant should be able to:
  • Identify currently recognized progressive forms of multiple sclerosis (MS) and explain their relationship to each other and to relapsing-remitting MS
  • Examine recommendations and practice patterns for the use of disease-modifying therapy in patients with progressive forms of disease
  • Discuss findings of previous studies of approved MS therapies in progressive forms of MS
  • Analyze recent research studies to evaluate the potential of novel agents and standard therapies in neuroprotection and neurorepair in progressive forms of MS
Disclosure
Disclosure of Non-endorsement of Products
Approval does not imply endorsement by the CMSC or ACCME of any commercial products discussed in conjunction with an educational activity.

Disclosure of Unlabeled Use
This CME activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. CMSC, Teva CNS, and Delaware Media Group do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the CMSC, Teva CNS, or Delaware Media Group.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients' conditions, considering possible contraindications or risks, reviewing any applicable manufacturer's product information, and comparing any therapeutic approach with the recommendations of other authorities.
Accreditation and Designation
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Consortium of Multiple Sclerosis Centers (CMSC) and the Delaware Media Group. The CMSC is accredited by the ACCME to provide continuing medical education for physicians.

The CMSC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Release Date: December 31, 2013
Credit for this program expires on December 31, 2014.
Method of Participation
Follow these steps to earn CME credit:
  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. The CMSC encourages you to complete the Activity Evaluation to provide feedback for future programming.
Code: CMSC-DELMED 2013/3
Privacy Policy and Confidentiality
CMSC is committed to honoring the privacy of participants in educational activities. Our full privacy policy is available on our website at http://www.mscare.org/privacy.aspx
Other Information
Jointly sponsored by the Consortium of Multiple Sclerosis Centers and Delaware Media Group.

This continuing education publication is supported by an educational grant from Teva CNS.

For questions relating to CME, please contact the CMSC at (201) 487-1050 or email education@mscare.org.
Hardware/Software Requirements
The minimum requirements for viewing an on-line book is an active internet connection and Flash (free software from Adobe) version 10 or higher.
Link to the Program
Agree Button



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The Role of Gender in MS Disease Progression and Treatment

The Science of MS Management: 
The Role of Gender in MS Disease Progression and Treatment

Corey C. Ford, MD, PhD; Rhonda Voskul, MD
CME/CE Released: 03/31/2014; Valid for credit through 03/31/2015
Faculty and Disclosures
Corey C. Ford, MD, PhD
Dr. Ford has disclosed the following financial relationships:
Sources of Funding for Research: Biogen Idec, Elan, Genentech, Genzyme, Janssen, Novartis, Ono Pharmaceutical, Sanofi Aventis, Serono, and Teva CNS.
Consulting Agreements: Biogen Idec, Novartis, and Teva CNS.
Rhonda Voskuhl, MD
Dr. Voskuhl has disclosed no relevant financial relationships.
Reviewer
Laurie Scudder, DNP, NP
Laurie Scudder has disclosed no relevant financial relationships.
Planners and Managers
The following planners and managers have disclosed no relevant conflicts of interest: Joseph J. D’Onofrio, Frank Marino, Nancy Monson, Katherine Wandersee.

Target Audience
This publication is targeted to neurologists and physicians who have an interest in treating multiple sclerosis (MS).
Learning Objectives
Upon completion of this educational activity, the participant should be able to:
  • Describe the role of sex hormone fluctuations on underlying pathology, disease activity, and treatment efficacy in MS
  • Discuss the therapeutic potential of hormonal therapies such as testosterone and estrogen in the management of MS
  • Review current research findings relating to sex hormones in MS, including chromosomal and genetic studies
Disclosure
Disclosure of Non-endorsement of Products
Approval does not imply endorsement by the CMSC or ACCME of any commercial products discussed in conjunction with an educational activity.

Disclosure of Unlabeled Use
This CME activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. CMSC, Teva CNS, and Delaware Media Group do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the CMSC, Teva CNS, or Delaware Media Group.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients' conditions, considering possible contraindications or risks, reviewing any applicable manufacturer's product information, and comparing any therapeutic approach with the recommendations of other authorities.
Accreditation and Designation
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Consortium of Multiple Sclerosis Centers (CMSC) and the Delaware Media Group. The CMSC is accredited by the ACCME to provide continuing medical education for physicians.

The CMSC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Release Date: March 31, 2014
Credit for this program expires on March 31, 2015.
Method of Participation
Follow these steps to earn CME credit:
  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. The CMSC encourages you to complete the Activity Evaluation to provide feedback for future programming.
Code: CMSC-DELMED 2014/1
Privacy Policy and Confidentiality
CMSC is committed to honoring the privacy of participants in educational activities. Our full privacy policy is available on our website at http://www.mscare.org/privacy.aspx
Other Information
Jointly sponsored by the Consortium of Multiple Sclerosis Centers and Delaware Media Group.

This continuing education publication is supported by an educational grant from Teva CNS.

For questions relating to CME, please contact the CMSC at (201) 487-1050 or email education@mscare.org.
Hardware/Software Requirements
The minimum requirements for viewing an on-line book is an active internet connection and Flash (free software from Adobe) version 10 or higher.
Link to the Program
Agree Button








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Nausea, Dizziness, Vertigo - EXPLAINED





Nausea isn't the most commonly talked about symptom of MS, but it is enough to throw off your day. 













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Understanding Daclizumab - another MS Medication on the Horizon for FDA approval

Phase 3 results show that daclizumab reduces disease activity in relapsing-remitting multiple sclerosis by half compared with interferon, as measured by brain imaging, with skin and other side effects. The drug works in surprising ways that are revealing new details about the pathogenesis of MS.

Three might be the lucky number for daclizumab, an investigational drug for relapsing-remitting multiple sclerosis (RRMS) with broad and unexpected immune effects.

Under the brand name Zinbryta (Biogen Idec/AbbVie), a newly patented version of the drug, called daclizumab high-yield process, or DAC HYP, recently captured headlines after researchers presented more efficacy and safety results from the phase 3 clinical trial (Kappos et al., 2014).

The unpublished results seem to sustain expectations that daclizumab may be as effective as the best MS drugs now approved but with lower risk (Pfender and Martin, 2014). Meanwhile, researchers have identified at least three ways the drug works to counter MS, a finding that is illuminating new details in disease pathology and may lead to novel therapeutic strategies (Bielekova, 2013Pfender and Martin, 2014).

The phase 3 study, called DECIDE, is “a pivotal trial,” said Ellen  Mowry, M.D., M.C.R., a neurologist at Johns Hopkins University in Baltimore, Maryland. She cited the notable drop in disease activity as measured by relapses, MRI, and disability progression, compared to a popular older drug, interferon β-1a (Avonex, Biogen). She also noted daclizumab’s signature skin side effects as well as a small increase in serious infections.

Ludwig Kappos, M.D.
Ludwig Kappos, M.D.
Daclizumab “deserves to be approved and to be one of the options” available to people with MS and their physicians, said Ludwig Kappos, M.D., chair of neurology and head of the MS Research Group at University Hospital Basel, Switzerland, and lead investigator for DECIDE. The relative effectiveness of the drug could be “at least” at the level of fingolimod (Gilenya, Novartis) or dimethyl fumarate(Tecfidera, Biogen), Kappos speculated in an interview with MSDF. He cautioned that results of this and other drug studies cannot be compared directly, due to differences in design, selection criteria, and other details.

Kappos presented the DECIDE findings earlier this month at MSBoston2014, shorthand for the joint meeting of the Americas and European committees for treatment and research in multiple sclerosis (ACTRIMS-ECTRIMS), held September 10-13 in Boston. In the closing session, Mowry cited the findings as a clinical research highlight of the meeting.

Other meeting reports confirmed and extended some of the surprising ways daclizumab pulls the strings of the immune system. One of the new mechanisms of action has shown promise as an early biomarker of how the drug is working.

In another finding from the meeting, an analysis of samples from blood and cerebrospinal fluid suggests that daclizumab nudges the abnormal numbers of innate and adaptive immune cells in RRMS back to more normal physiological levels found in people without MS (Lin et al., 2014).

Top-level clinical findings

The double-blind phase 3 DECIDE trial pitted monthly injections of daclizumab against weekly interferon injections in people with RRMS for a minimum of 2 years. Each group received placebo injections of the other drug. A little more than 1,800 people started the 2-year DECIDE study. About two-thirds were women. On average, participants had had RRMS for about 4 years and mild disability of about 2.5 on the Expanded Disability Status Scale. About 30% dropped out for various reasons, mostly because of adverse events and lack of efficacy.

In the main finding, daclizumab reduced the annualized relapse rate by nearly half compared to interferon. Translated to an evidence-based medicine figure called “number needed to treat,” each patient on daclizumab had a 1-in-5.6 chance of having fewer relapses. In secondary endpoints, several brain imaging techniques also showed about half the new and enlarging lesions in the daclizumab treatment arm compared to interferon (Arnold et al., 2014).

Many of the top findings were reported in a press release in June. A new 6-month analysis presented at the meeting showed a slightly lowered risk of disability progression. Another new graph showed a reduction, although not statistically significant, in patient-reported physical decline (Kappos et al., 2014).

Skin and other side effects

The opposite trend was true with daclizumab’s distinctive side effect: skin adverse events, mostly rash and inflammation. More than one-third of people on daclizumab reported cutaneous issues, twice as many as in the interferon group, including some cases severe enough to discontinue the drug. The skin effects were independent of the injection site and were mostly manageable by corticosteroid creams, Kappos said.

Both groups had similar rates of injection site pain, about 10%, and daclizumab came out ahead on influenza-like illness, with 10% compared to 37% of people in the interferon group (Selmaj et al., 2014).




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