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Saturday, February 20, 2016

B Vitamin Promising in Progressive Multiple Sclerosis

Pauline Anderson
Washington, DC — A regimen of high doses of biotin, a water-soluble B vitamin, appears to be effective in patients with primary or secondary progressive multiple sclerosis (MS), according to emerging research.
A new phase 3 study of the investigational drug MD1003 (MedDay Pharmaceuticals), a highly concentrated pharmaceutical-grade biotin, found that patients with progressive MS taking the drug had significant improvement at 9 months, which was confirmed at 12 months, compared with those taking placebo.
"We are encouraged that the primary endpoint was met despite the very high bar for treatment response," said the study's principal investigator, Professor Ayman Tourbah, of CHU de Reims, Neurology, France, in a press release.
The results, he said, suggest that MD1003 "could be an important and efficacious treatment for primary and secondary progressive multiple sclerosis."
Currently, there are no effective therapies for progressive MS.
The results were presented at the Clinical Trials Plenary Session during the American Academy of Neurology (AAN) 67th Annual Meeting and again during a subsequent webcast.
Two Mechanisms
Biotin is a coenzyme for carboxylases, which are enzymes critical in energy metabolism and production of fatty acids. It targets two mechanisms that might be involved in progressive MS: promoting myelination and increasing energy production.
It's hypothesized that biotin may help to slow, stop, or even reverse the progression of disability associated with demyelination.
In his presentation, Dr Tourbah referred to a small uncontrolled "proof of concept" study of 23 patients with progressive MS who were treated with a mean of 300 mg of biotin per day for about 9 months. In this study, 22% of patients had a significant clinical improvement on the Expanded Disability Status Scale (EDSS).
The new study included 154 patients aged 18 to 75 years (mean age, about 51 years) with primary or secondary progressive MS and an EDSS score of 4.5 to 7. During the previous 2 years, they must have had a progression on the EDSS of at least 1 point if their baseline EDSS score was 4.5 to 5.5, and of 0.5 point if their baseline EDSS score was 6 to 7.
Patients were randomly assigned to placebo (n = 51) or to oral MD1003 (n = 103), which is tasteless and colorless. The mean dose of the drug was 300 mg/day. About 41% of the treatment group and 55% of the placebo group were also taking fampridine, a drug used to manage MS symptoms.

continue from Medscape


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INFORMS Published: Fingolimod Fails in Primary Progressive MS

February 19, 2016

Full details of the INFORMS trial have confirmed that the multiple sclerosis (MS) drug fingolimod did not slow progression of disability or brain volume loss vs placebo in the primary progressive form of the disease.
The trial results have now been published online in The LancetJanuary 27, with lead author Fred Lublin, MD, The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, New York. Top-line results were announced previously by Novartis.
In the Lancet paper, Professor Lublin and colleagues note that fingolimod did show an anti-inflammatory effect in the INFORMS trial, significantly reducing the numbers of gadolinium-enhancing and new T2 lesions on brain MRI. However, unlike the situation with fingolimod in relapsing-remitting MS, this had little effect on the process that leads to brain volume loss and disability progression in the primary-progressive MS population.
They conclude that: "The results of INFORMS suggest that anti-inflammatory strategies applied at present in relapse-onset multiple sclerosis are unlikely to be beneficial in primary progressive multiple sclerosis, and that novel approaches might be needed to treat patients with primary progressive multiple sclerosis.

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Understanding Treatment Options and Individualizing Therapy in MS - CME/CNE Activity


MS leaders e-mail logo header 

Dear MS-Leaders Registrant,

Can you correctly answer this question:  
     
Which of the following factors has been confirmed as a predictor of worse prognosis in multiple sclerosis (MS)?
A. Female gender
B. Age <40 years at presentation
C. T1 black holes on baseline MRI
D. No indication of myelomalacia

Participate in our Clinical Dialogue and eCase Challenge to learn the answer to this and other questions related to MS therapy. 

Earn up to 1.5 Free CME or 1.6 Contact Hours for Nurses!

The University of Texas Southwestern Medical Center, Postgraduate Institute for Medicine and Medical Logix, LLC, are pleased to offer this new educational program certified for CME/CNE credit, at no charge to participants:

Activity valid for credit through October 1, 2016

Acknowledgement of Commercial Support: 
Supported by an independent educational grant from EMD Serono.
Intended Audience:
This activity is intended for healthcare professionals, specifically, neurologists, internists, family practice physicians, nurse practitioners, physician assistants, registered nurses and other providers involved in the care of patients with multiple sclerosis.

Accreditation Statement:
ACCME - This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of The University of Texas Southwestern Medical Center and Medical Logix LLC. The University of Texas Southwestern Medical Center is accredited by the ACCME to provide continuing medical education for physicians.
ANCC - Postgraduate Institute for Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Credit Designation:
ACCME - The University of Texas Southwestern Medical Center designates each of these enduring materials for a maximum of 0.75 AMA PRA Category 1 CreditsTM. Participants should claim only the credit commensurate with the extent of their participation in the activity.
ANCC - This educational activity for 1.6 contact hours is provided by Postgraduate Institute for Medicine. (0.8 per part)

Format and Method of Participation:
There are no fees for participating and receiving CME or CNE credit for this activity. During the accreditation period, participants must read the learning objectives and faculty disclosures and review this internet-based activity. To take the post-test, please click on the post-test button below the slide window of the player. Complete the post-test and evaluation and attest to the amount of time spent in the activity. Upon receiving a score of 70% or above, print your CME or CE certificate.
For CME questions, please contact the UTSW Office of CME at (214) 648-2166.  For CE questions please contact Postgraduate Institute for Medicine at http://www.pimed.com/.
Please keep in mind that you will need to login with your email address and password to access this program. If you forgot your password, click on the "Forgot Password" link in the top right corner of the site.
We hope you enjoy this informative educational program!


The MS-Leaders Team


Produced in cooperation with:
Medical Logix, LLC



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Friday, February 19, 2016

A Look at the Invisible Symptoms of MS - with Brian Steingo, MD



Published on Aug 14, 2014
REALLY? – But You Look SO GOOD!
A Look at the Invisible Symptoms of MS

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Click below to see more videos from various speakers, on the Invisible Symptoms of MS




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Mood & Cognition in MS


Published on Sep 22, 2014
Our understanding of the role that mood and cognition play in a person’s experience of multiple sclerosis has expanded dramatically in recent years. We now understand that both these types of “invisible symptoms” can be a direct result of the disease process, and can change over time.




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Spasticity and MS: How to Control Your Muscles

Many people with multiple sclerosis have stiff muscles and spasms, a condition called spasticity. It happens mostly in the muscles of the legs and arms, and it may keep you from moving your limbs freely.
You might feel spasticity either as stiffness that doesn’t go away or as movements you can’t control that come and go, especially at night. It can feel like a muscle tightening, or it can be very painful. Spasticity also can make you ache or feel tight in and around your joints and low back. How you feel can vary depending on your position, posture, and how relaxed you are.
Click any of the above links to learn more
Source: WebMD


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Treatment for Speech Problems

If muscle stiffness is making it hard for you to speak, medications might help. Your speech therapist might also suggest:
  • Exercises to strengthen or relax your vocal cords or improve how you move your jaw, tongue, and lips
  • Strategies other than speech that can help you communicate with others. You might focus on using shorter words and phrases or ways to simplify words, sentences, or sounds.
  • Practice controlling your breath. It can help you speak longer sentences in one breath or accent specific words.
There are other ways to manage your speech problems, too:
  • Don’t feel rushed or pressured when you’re trying to talk. If you feel comfortable, it may help to let the other person know you have a speech problem.
  • Try to talk with someone face-to-face whenever possible. Your facial expressions and gestures can help you get your point across.
  • If a conversation goes on too long, ask if you can take a break.
  • Try to relax. If you can keep a positive attitude, it might put you and the other person at ease so you won’t feel anxious about understanding each other.


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Speech and Swallowing Problems from MS?


Missing Images! People with multiple sclerosis, or MS, often have trouble swallowing, a problem called dysphagia. It can also lead to speech problems. It happens when the disease damages the nerves in the brain and spinal cord that make these tasks happen.
For some people, these problems are mild. Others have a harder time dealing with severe symptoms. But treatments and techniques can help you improve your speech and make swallowing easier.

Symptoms of a Swallowing Problem

You might:
  • Cough or choke when you eat
  • Feel like food is lodged in your throat
  • Get a lot of lung infections, like pneumonia, that you can’t explain
When you can’t swallow properly, you might inhale food or liquids into your windpipe instead of getting them down your esophagus and into your stomach. Once in the lungs, they can cause pneumonia or abscesses. You could also be at risk for malnutrition or dehydration because your food and water aren’t getting to your stomach.

Symptoms of Speech Problems

The kinds of speech problems MS causes can vary depending on which part of the brain is damaged. Someone with the disease might have mild trouble with words or severe problems that make it hard for them to speak and be understood. A problem that’s subtle in the beginning might get worse over time.
People with MS usually have a few distinctive language problems:
  • “Scanning" speech, when a person’s normal speech pattern is disrupted with long pauses between words or syllables
  • Slurring words. It usually happens because of weak tongue, lip, and mouth muscles.
  • Trouble changing tone of voice
  • Nasal-sounding speech

Getting a Diagnosis

Your doctor will ask you about your symptoms and do a physical exam, paying attention to how well your tongue and other muscles in your mouth and throat work.
Click here to read and learn more from WebMD



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MS Views and News 
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Tools to Help You Remember

You can keep your memory sharp with some easy tips and tricks -- from old-fashioned sticky notes to high-tech gadgets.

Tools to Help You Remember

Digital recorder. Carry one with you. When you need to remember a name, phone number, or date, record a note to yourself. Write down the info or type it into your computer when you get home.
Cell phone camera. Use it to snap a photo of new people, places, and things. Email the pictures to yourself with a note so you'll remember them later.
Calendar. Use the one on your computer or cell phone to keep track of your schedule. Set it to send you reminders a few days or hours before a birthday, meeting, or other event.
If you're not a big fan of technology, write important dates on an old-fashioned paper calendar.
GPS system. Get one for your car and put an app on your cell phone so you don't get lost. Type in the address you're going to and you'll get step-by-step directions by car or on foot.
Buy a pillbox. Use it to organize your daily medicine. Some have built-in alarms that alert you when it's time to take your medicine.

Tricks to Keep Organized

White board. Put one on your fridge or other area where you spend a lot of time. Write notes and to-do lists on it.
Post-it notes. They're a good way to jog your memory. Stick them around your house, office, and in your car.
Box or bin for everyday items. Place it in a central area, like the kitchen. Put in your car keys, glasses, and other things you often use. You can also set aside a folder for important papers.
Continue reading from WebMD

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MS Views and News 
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Keep current with Multiple Sclerosis news and information 
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Pomegranate and MS: Therapeutic Potential

MS_pomegranate_socialclip2



In a recent study, researchers show how a natural antioxidant within pomegranate seeds is capable of inhibiting demyelination in a mouse model for multiple sclerosis (MS), supporting novel formulations of natural antioxidants as therapeutics for demyelinating diseases. The study, “Treatment of a multiple sclerosis animal model by a novel nano drop formulation of a natural antioxidant,” was published in the International Journal of Nanomedicine.
The results from this study suggest that Nano-PSO has a therapeutic potential both for preventing the disease and for impairing its progression.
Read more about this here: http://bit.ly/1LgEFYD

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MS Views and News 
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EMA advocates more regular MRIs for MS patients on Biogen’s mAb Tysabri

By Gareth MacDonald+, 17-Feb-2016
Multiple sclerosis patients taking Tysabri (natalizumab) who are deemed to be at high risk for the lethal infection PML should have regular brain scans according to the EMA. 

READ this important article found here:



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Thursday, February 18, 2016

Itching and Multiple Sclerosis

Pruritis (itching) may occur as a symptom of MS. It is one of the family of abnormal sensations — such as “pins and needles” and burning, stabbing, or tearing pains — which may be experienced by people with MS. These sensations are known as dysesthesias, and they are neurologic in origin.
Dysesthetic itching may occur suddenly and intensely, but for brief periods. It may be present over any part of the body or face. It is different from the generalized itching that can accompany an allergic reaction, as there is no external skin rash or irritation at the site of itching. Corticosteroid ointments applied to the skin are not helpful in relieving this type of dysesthetic itching. There are, however, several medications that are usually successful in treating dysesthetic itching. Among them are:
People who experience itching should consult their physician.
Source link: http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Itching 

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MS Views and News 
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Keep current with Multiple Sclerosis news and information 
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