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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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Thursday, December 31, 2015

Vitamin D news


"These results are exciting, as vitamin D has the potential to be an inexpensive, safe and convenient treatment for people with multiple sclerosis," said study author Peter Calabresi from Johns Hopkins University School of Medicine in the US.

Low levels of vitamin D in the blood are tied to an increased risk of developing MS and are more likely to have greater disability and more disease activity.

The current recommended daily allowance of vitamin D is 600 international units.

For the study, 40 people with relapsing-remitting MS received either 10,400 international units or 800 international units of vitamin D supplements per day for six months.

Patients with severe vitamin D deficiency were not included in the study.

Blood tests at the start of the study and again at three and six months measured the amount of vitamin D in the blood and the response in the immune system's T cells, which play a key role in MS.

Learn More





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Monday, December 28, 2015

The Basics of MS Treatments


Listen to this MS Neurologist discuss the MS Treatments available now as opposed to what was available 20 years ago..



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MSVN Goals -- Thinking of the Present and the Future






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Anti-SPAG16 antibodies in primary progressive multiple sclerosis are associated with an elevated ...

Abstract

BACKGROUND AND PURPOSE:

Sperm-associated antigen 16 (SPAG16), a sperm protein which is upregulated in reactive astrocytes in multiple sclerosis (MS) lesions, has recently been identified as a novel autoantibody target in MS. The aim of this study was to investigate whether anti-SPAG16 antibody levels differ between MS subtypes (relapsing-remitting, RR; primary or secondary progressive, PP, SP) and whether antibody positivity is associated with clinical characteristics.

METHODS:

Plasma anti-SPAG16 antibody levels were determined by recombinant protein enzyme-linked immunosorbent assay (ELISA) in 374 MS patients (274 RRMS, 39 SPMS and 61 PPMS) and 106 healthy controls.

RESULTS:

Significantly elevated anti-SPAG16 antibodies were found in 22% of MS patients with 93% specificity. Anti-SPAG16 seropositivity was associated with an increased Expanded Disability Status Scale (EDSS) in overall MS. A higher proportion of PPMS patients showed anti-SPAG16 antibody reactivity (34%) compared to RRMS (19%) and SPMS (26%), and presented with higher anti-SPAG16 antibody levels. Seropositive PPMS patients had a significantly increased progression index compared to seronegative patients.

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MS Patients Show Better Gait and Balance with Dalfampridine Treatment


Withdrawal/re-initiation study expands on known walking speed benefits of approved MS therapy

In a new study, researchers evaluated the effect of dalfampridine treatment in people with multiple sclerosis (MS) and observed significant improvements in not only walking speed and distance, but also in gait and balance. The paper, titled “Dalfampridine Effects Beyond Walking Speed in Multiple Sclerosis,” was published in the International Journal of MS Care.
MS is a debilitating disease in which cells of the immune system attack the central nervous system (CNS), namely nerve fibers and myelin, the element that covers and protects nerve cells. The symptoms and severity of MS vary greatly from patient to patient, although functional limitations such as walking/gait dysfunction and balance impairment are fairly common. Walking difficulties arise from factors such as muscle weakness, spasticity (muscle tightness), balance problems, sensory deficits, and fatigue.
Dalfampridine in extended release (ER) form (Ampyra extended-release tablets; Acorda Therapeutics Inc.) has been shown to rehabilitate conduction in demyelinated nerves in animals. Data from two Phase 3 clinical trials showing that dalfampridine-ER was able to improve walking speed in MS patients was key to its being granted approval in the United States in 2010.

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CVS/Caremark Formulary Changes for Plegridy and Avonex



As some of you may have learned from correspondence received from CVS/Caremark, effective January 1, 2016, PLEGRIDY® (peginterferon beta-1a) and AVONEX® (interferon beta-1a) will be excluded from a subset of CVS/Caremark commercial health insurance plans. This change will NOT impact all patients who have CVS/Caremark health insurance. 
Therapy decisions are best left to be determined by patients and their physicians. There are actions that patients and their physicians can take to ensure that they can remain on their current therapy. Individuals impacted by CVS/Caremark’s decision can work with their physicians as follows:


  • The physician can submit a medical exception/letter of medical necessity directly to CVS/Caremark
  • If the medical exception letter is not successful, an appeal can be filed
  • During the appeal process, the patient may be eligible to receive interim doses from Biogen to ensure there is no disruption in treatment
  • If the appeal is denied, patients may be eligible for Biogen’s patient assistance programs
  • Patients that need assistance in understanding and navigating their health insurance coverage can contact Biogen Support Coordinators at 1-800-456-2255; M-F, 8:30am – 8:00pm EST
  • Through the support program, Biogen is committed to helping patients and provides support services to patients and caregivers, such as financial and insurance support, nurse educators, support coordination, and peer connections




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Friday, December 25, 2015

Parenting With MS

By 
WebMD Feature
Reviewed by Richard Senelick, MD
MS can't stop you from being a great parent. The key is to focus on your strengths and learn creative ways to work around your symptoms.
Your condition will shape your outlook and approach to parenting. And that could be a good thing.
"Having MS made me a better parent than I would have been without it," says Matt Cavallo, who has known he had MS since 2005. He now has two young boys.

What MS Can Teach You About Parenting

Know what's important. Because you live with an unpredictable disease, you understand something about life that most people don't. "Before I had MS, I was someone who worked 15-hour days; my mind always on the next big project," says Cavallo, who is also an author and motivational speaker. "MS makes you aware of how life can change at any time. You learn to focus on appreciating the moment."
Expect the unexpected. MS teaches you to be flexible and adaptable. "Any parent knows that the best possible plans can veer horribly wrong at any moment because of a meltdown or sick kid," Cavallo says.
Be a role model. "Your kids will understand we all face challenges, but they'll see you succeeding despite them," says Cindy Richman, senior director of patient and health care relations at the Multiple Sclerosis Association of America. "Your example will make them more resilient and confident."

Tips for Parenting With MS


Take care of yourself. Give yourself plenty of downtime and rest. "Tending to your own needs isn't selfish," says Rosalind Kalb, PhD, a clinical psychologist and vice president of clinical care at the National Multiple Sclerosis Society. If you overdo it one day, it could take you a week to recover -- and that's not good for anyone.
Continue reading this article from WebMD


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Women's Health Issues with MS - (recorded 12.16.2015 in Orlando, Fl.)


Presented by: MS Nurse Practitioner Specialist, Guest Speaker: 
Patricia Pagnotta, ARNP, MSN, CNRN, MSCN / Co-Director of MS Views and News first Medical Advisory Committee. 
 --- Patricia speaks about: MRI, MS Treatments, Psychological Factors like Resilience, Depression, Anger, Excitability, Self Aspects, Bladder Problems, Sexual Issues, Nutrition, Keeping Positive, Symptom Management relating to topics mentioned, Parenting, Family Living & When to tell the children, Plus Dating (and when to tell) and Discussion on the workplace and what to expose...
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For the MS patient-clinician, communication tool, 
please click here to access




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Thursday, December 24, 2015

Study of key enzymes in energy metabolism may help in understanding of axonal degeneration

MS Active and Inactive Lesions Differ in Levels of Enzymes that Drive Glucose Metabolism

Dec 21, 2015

<span class="entry-title">MS Active and Inactive Lesions Differ in Levels of Enzymes that Drive Glucose Metabolism</span><span class="entry-subtitle">Study of key enzymes in energy metabolism may help in understanding of axonal degeneration</span>

A research team recently showed that key enzymes of energy metabolism pathways are differentially expressed in active and inactive multiple sclerosis (MS) lesions, and may contribute to axonal degeneration in MS. The study, titled “Differential expression of glucose-metabolizing enzymes in multiple sclerosis lesions,” was published in the journal Acta Neuropathologica Communications.
MS is an immune-mediated disease of the central nervous system characterized by the destruction of the myelin layer within nerve cells, leading to a wide range of neurological symptoms (affecting sensory, motor, autonomic, and neurocognitive functions) that manifest usually between the ages of 20 and 40.
Over time, the number of new lesions formed decreases, and the disease progresses with neuron cell degeneration and the dysfunction of axons (a long, slender projection of a nerve cell that conducts the electric impulses from the cell body to other cells). Damaged, demyelinated axons need to consume more energy to maintain electric conduction, and as a consequence, MS axons contain more mitochondria (the organelles responsible for energy production). Notably, increasing evidence suggests that mitochondrial dysfunction and associated oxidative stress drive neurodegeneration in MS. A possible mechanism accounting for this phenotype is the fact that damaged mitochondria may change glucose metabolism, therefore impairing the neurons’ function in MS patients.

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MS Patients Using New Web-based Program to Manage and Integrate Care

A team of researchers from the Netherlands have developed an interactive web-based program called MSmonitor that offers multiple sclerosis patients a way to manage and better integrate the multidisciplinary care they require. Pilot data from a study of its use is detailed in the article, “The interactive web-based program MSmonitor for self-management and multidisciplinary care in multiple sclerosis: concept, […]
Read More »



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The Needed Roots in MS Care - Customizing Therapy - Another Beneficial MS program



(43rd program of 2015) December 15, 2015 - from Jacksonville, Florida -
 
Our second speaker of this program - Speaking After our Social Security Disability attorney:
MS Specialist  Megan Weigel, DNP, ARNP-C, MSCN,

Megan Discussion includes: Current Disease Modifying Treatments, Adherence, Compliance, Gait issues & MS Relapse plus Enhancing Quality of Life for Patients With MS.


For those that want to see the first portion of this program with the Social security disability attorney, please click: https://youtu.be/9qhQy8j0Cpk


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Denver Artist Sarah Richter Finds The 'Beauty' Of Having MS

Reported by Stephanie Wolf/CPR News
Dec 22, 2015

Denver artist Sarah Richter stands in front of a sound sculpture featured in her multi-media installation "Sensory Paradox" at CU Anschutz Medical Campus in Aurora on Dec. 8, 2015. 

Seeing three of everything can be disorienting. That's what happened to Denver artist Sarah Richter in 2009. "One day I woke up, and I saw the world totally differently," Richter says. "It was very painful and frightening. But it was really beautiful too."
Doctors diagnosed Richter with multiple sclerosis. Since then, she has used her art to explore how MS affects her body. She recreates what she calls the "invisible symptoms" in her latest project"Sensory Paradox: An Artist's Experience with Multiple Sclerosis." It's on display through March 3 at the University of Colorado Anschutz Medical Campus in Aurora. Richter spoke with Colorado Matters host Ryan Warner.
- CONTINUE



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Sunday, December 20, 2015

Clinical features of neuromyelitis optica in children: US Network of Pediatric MS Centers report

Abstract

OBJECTIVE:

To compare clinical features of pediatric neuromyelitis optica (NMO) to other pediatric demyelinating diseases.

METHODS:

Review of a prospective multicenter database on children with demyelinating diseases. Case summaries documenting clinical and laboratory features were reviewed by an adjudication panel. Diagnoses were assigned in the following categories: multiple sclerosis (MS), acute disseminated encephalomyelitis, NMO, and recurrent demyelinating disease not otherwise specified.

RESULTS:

Thirty-eight cases of NMO were identified by review panel, 97% of which met the revised International Panel on NMO Diagnosis NMO-SD 2014 criteria, but only 49% met 2006 Wingerchuk criteria. Serum or CSF NMO immunoglobulin G (IgG) was positive in 65% of NMO cases that were tested; however, some patients became seropositive more than 3 years after onset despite serial testing. No patient had positive CSF NMO IgG and negative serum NMO IgG in contemporaneous samples. Other than race (p = 0.02) and borderline findings for sex (p = 0.07), NMO IgG seropositive patients did not differ in demographic, clinical, or laboratory features from seronegatives. Visual, motor, and constitutional symptoms (including vomiting, fever, and seizures) were the most common presenting features of NMO. Initiation of disease-modifying treatment was delayed in NMO vs MS. Two years after onset, patients with NMO had higher attack rates, greater disability accrual measured by overall Expanded Disability Status Scale score, and visual scores than did patients with MS.

CONCLUSION:

The new criteria for NMO spectrum disorders apply well to the pediatric setting, and given significant delay in treatment of NMO compared to pediatric MS and worse short-term outcomes, it is imperative to apply these to improve access to treatment.
© 2015 American Academy of Neurology.


SOURCE



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Saturday, December 19, 2015

Fourth PML Case With Tecfidera in MS Calls for Vigilance

December 17, 2015

After a fourth case of progressive multifocal leukoencephalopathy (PML) linked to the multiple sclerosis (MS) drug dimethyl fumarate (Tecfidera, Biogen), it is becoming more widely accepted that even the "safer" immunosuppressant agents may cause dangerous adverse effects, albeit rarely, and vigilance on this issue is required, experts say.
Tecfidera, an oral agent taken twice daily, has been available for the treatment of MS since 2013. The generic compound, dimethyl fumarate, and similar products containing fumaric acid esters have long been used to treat psoriasis. As well as the four cases of PML in patients with MS, about 10 cases in patients with psoriasis have been linked to such products, Ari Green, MD, from the University of California San Francisco, told Medscape Medical News.
There have also been three cases of PML with fingolimod, another oral MS treatment thought to be relatively safe in terms of opportunistic infections.
PML is a rare but potentially fatal brain infection caused by the JC virus. It is seen mainly in immunosuppressed individuals and has been a particular problem with the potent immunosuppressant natalizumab (Tysabri), an effective treatment for MS.
Biogen acknowledged to Medscape Medical News that a fourth case has occurred but declined to disclose case details.
"We can confirm that we have reported a fourth case of progressive multifocal leukoencephalopathy (PML) from October 2015 associated with Tecfidera treatment in an MS patient that had experienced prolonged lymphopenia," a spokesperson for Biogen public affairs noted. "We are not providing case details on this particular AE [adverse event] other than through normal medical, regulatory and safety channels."

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Alkermes enrolling MS patients to assess safety of ALKS 8700 (MMF) compared to Tecfidera

New MS Drug Therapy Based on Monomethyl Fumarate 
Moving Along in Testing

Dec 18, 2015

Alkermes plc, a biopharmaceutical company focused on therapies for the treatment of central nervous system (CNS) disorders, announced that it has successfully met its 2015 goals for their product and late-stage pipeline drug portfolio, including ALKS 8700, a monomethyl fumarate (MMF) drug candidate for the treatment of multiple sclerosis (MS).
Alkermes launched pivotal clinical development programs for two of its pipeline drugs: ALKS 8700, a new, oral MMF drug for MS treatment, and ALKS 3831, a new, oral atypical antipsychotic drug for the treatment of schizophrenia.
MMF is thought to have immunomodulatory and anti-inflammatory properties, although its mechanism of action is still not clear. ALKS 8700 is a drug designed to quickly and efficiently convert to MMF inside the patient’s body, offering distinct features from the marketed MS therapy dimethyl fumarate (Tecfidera).
ALKS 8700 pivotal program EVOLVE (Endeavoring to Advance Treatment for Patients Living with Multiple Sclerosis) comprises two studies. EVOLVE-1 is a multicenter, two-year, open-label trial to evaluate ALKS 8700 safety in 600 MS patients. This ongoing study is currently enrolling participants. Alkermes is planning to register ALKS 8700 based on data from EVOLVE-1, and on pharmacokinetic bridging results from studies where ALKS 8700 was compared to Tecfidera, and feedback obtained from the U.S Food and Drug Administration (FDA). The company also plans to conduct a second randomized, head-to-head study (EVOLVE-2) in 2016 to compare the gastrointestinal tolerability of ALKS 8700 to Tecfidera in up to 420 MS patients.
READ more



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Friday, December 18, 2015

MS Study Uncovers a Process Leading to Neuroinflammation in the Brain

In a new study, researchers from the University of Toronto, Canada, uncovered the process behind the formation and maintenance of tertiary lymphoid tissues (TLTs), structures found in the meninges in the brains of multiple sclerosis (MS) patients. Their findings, reported in the article “Integration of Th17- and Lymphotoxin-Derived Signals Initiates Meningeal-Resident Stromal Cell Remodeling to Propagate […]

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New MS Drug Shows ‘Excellent Profile’ in Preclinical Tests Against Approved Therapy

Akaal Pharma, a developer of small molecule drugs for the treatment of inflammation and autoimmune diseases including multiple sclerosis (MS), recently announced highly positive preclinical trial results on the safety and efficacy of its drug candidate AKP-11 when compared to Gilenya (fingolimod, FTY-720), an oral MS drug approved by the U.S. Food and Drug Administration […]

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MS May Be Triggered by the Death of Brain Cells

Researchers are proposing for a first time that multiple sclerosis (MS) is triggered by the death of a specific cell population within the central nervous system called oligodendrocytes. The study, titled “Oligodendrocyte death results in immune-mediated CNS demyelination,” was published in the journal Nature Neuroscience. Oligodendrocytes, together with Schwann cells, are the central nervous system (CNS) cells responsible […]

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MS Nerve Degeneration Triggered by Chain Reaction in Cells

Researchers in the United Kingdom recently discovered that a small molecule triggers the destruction of axons, a phenomenon observed in neurodegenerative diseases like multiple sclerosis (MS). The study is titled “Wallerian Degeneration Is Executed by an NMN-SARM1-Dependent Late Ca2+ Influx but Only Modestly Influenced by Mitochondria” and appears in the journal Cell Reports. Neurons communicate and transmit electrical signals […]

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Study Recruiting MS Patients to Assess Exercise and Behavioral Therapy

Dr. Bradley Bowser, a South Dakota State University (SDSU) researcher and assistant professor, is investigating whether the practice of exercise, either by itself or together with cognitive behavioral therapy, can effectively improve mobility and quality of life in patients with multiple sclerosis (MS). MS is a neurodegenerative condition that often induces motor disability. Motor symptoms like […]

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Does the Nose Know in MS?

Olfactory dysfunction linked to disease activity and more

Olfactory dysfunction may occur in 20% to 45% of patients with multiple sclerosis (MS), according to a literature review.


The review also uncovered findings that suggest a relationship between mood disorders, cognition, and olfactory dysfunction in MS, reported Elizabeth B. Lucassen, MD, of the Pennsylvania State University-Milton S. Hershey Medical Center in Hershey, and colleagues.

Not only can olfactory dysfunction frequently be measured in MS patients, but both threshold and identification deficits can be observed, the investigators wrote online in Multiple Sclerosis and Related Disorders.

They also noted that olfactory dysfunction in MS correlates with disability, as measured by the Expanded Disability Status Scale (EDSS), and that measurements of olfactory dysfunction may wax and wane with relapses.

Read More

Article provided by: Cherie C. Binns RN BS MSCN - Clinical Systems Consulting


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