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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, for your personal knowledge and to keep you informed of current health-related issues. It is not 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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Saturday, February 17, 2018

video: 10 Tips to Combat Social Isolation in Multiple Sclerosis [2018]

By: Aaron Boster, MD - February 2018



10 Tips to Combat Social Isolation in Multiple Sclerosis [2018] Social Isolation is all too common amongst people with Multiple Sclerosis (MS). Dr. B offers 10 tips to combat social isolation: 10. participate in the online community. People who share your interests are out there on Twitter, Facebook, Instagram, YouTube and many many more. 9. Become a pen pal! 8. Set up a standing weekly phone date with a loved one or good friend 7. Complete some paperwork at a cafe instead of the home office 6. Take your workout outside of the home. Consider going to the park, taking group yoga or barre class, lifting at a rec center or joining a local gym. 5. Set up a standing monthly lunch date with a friend across town 4. Join a support group! Find a group right for you (ask your provider or check with the local NMSS chapter) 3. Sign up for a class at your community rec center! Underwater basket weaving at noon on Wednesdays! 2. Volunteer. It feels so good to give back. Usher at church, read to kids in a library, help with dinner at a soup kitchen. 1. The number one tip...GET A PET! Which tips sound right for you? What have you tried you could share with us? Please leave your own tips, your comments and questions below! #WeHaveMS



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video: Multiple Sclerosis and Dogs: 7 reasons people with MS should own a dog

Video by Aaron Boster, MD

Multiple Sclerosis and Dogs: 7 reasons people with MS should own a dog Reason #7 is health benefits. Owning a dog lowers blood pressure, lowers depression, lowers anxiety and lowers stress levels. That's very cool! Reason #6 Many dogs can be trained as therapy dogs. There are many really cool video's on YouTube about therapy dogs. Check them out! Watch this video to learn 5 more reasons people with MS should own a dog! Do you own a dog? Have you identified benefits I left out? Please share with use! Kindly leave your questions and comments below! #WeHaveMS #PetsOfMS, #MSViewsandNews,

OhioHealth MS Center: http://ow.ly/GSUX30i2mtG YouTube: https://www.youtube.com/c/AaronBosterMD

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Ipsen Announces Dysport® (abobotulinumtoxinA) Data Presentations Highlighting Duration of Response and Potential Benefit of Repeated Treatment in Spasticity

Oral Presentations at the 2018 Annual Meeting of the Association of Academic Physiatrists (AAP) Provide Additional Data on the Safety and Efficacy of Dysport® in Adults with Upper and Lower Limb Spasticity and Children with Lower Limb Spasticity 

BASKING RIDGE, N.J., February 15, 2018 – Ipsen Biopharmaceuticals, Inc., an affiliate of Ipsen (Euronext: IPN; ADR: IPSEY) (Ipsen), announced Dysport® (abobotulinumtoxinA) data will be presented today in two oral presentations at the annual meeting of the Association of Academic Physiatrists (AAP) being held in Atlanta, February 13-17, 2018. The oral presentations provide the outcomes of multiple Phase 3 studies that evaluated time to retreatment, as well as long-term treatment with Dysport® .

“The data being presented at this year’s AAP meeting indicate that Dysport® provides sustained spasticity relief for both adult and pediatric patients,” said David Cox, Vice President, US Medical Affairs, HEOR & Commercial Regulatory Affairs, Ipsen. “Improved outcomes from long-term therapy along with longer time between injections can be important factors in the management of these conditions, and we’re pleased to share these data to help inform physician and patient treatment decisions.”

In the first oral presentation, results from three randomized, placebo-controlled, double-blind Phase 3 studies of Dysport® evaluating time to retreatment in three patient groups showed that 37 percent of hemiparetic (post-stroke/traumatic brain injury) patients with adult upper limb spasticity (AULS), 20 percent of hemiparetic patients with adult lower limb spasticity (ALLS) and 74 percent of patients with pediatric (at least two years of age) lower limb spasticity (PLLS) due to cerebral palsy did not require reinjection until week 16 or later (Abstract #361196).

Learn more by clicking here



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Wednesday, February 14, 2018

Stem Cell Treatment Benefits Three-fourths of MS Patients in Phase 1 Trial

February 14, 2018

Stem Cell Treatment Benefits Three-fourths of MS Patients in Phase 1 Trial

A stem cell treatment improved the neurological symptoms of three-fourths of the multiple sclerosis patients in a Phase 1 clinical trial, New York researchers reported.
The results prompted the team at the Tisch MS Research Center of New York to start a Phase 2 trial to further assess the therapy’s safety and effectiveness.
Injecting mesenchymal stem cell-derived nerve cell progenitors directly into the spinal canal also improved the muscle strength and bladder function of many of the 20 progressive MS patients.
Eighty percent, or 16, of the patients in the open-label trial (NCT01933802) had secondary progressive MS.
Half were unable to walk at the beginning of the study, and had EDSS disability scores of 7 or higher. Eight required assistance to walk, and had EDSS scores of 6 to 6.5. Two were able to walk without assistance, with EDSS scores between 3.5 and 5.5. EDSS stands for Expanded Disability Status Scale.
The stem cell treatment led to improvements in 15 of the 20 patients’ neurological symptoms. The disease of two worsened, and the condition of three remained the same.
Fourteen of the patients had better muscle strength after the treatment, mainly in the lower limbs. Four of the 10 patients who were able to walk when the trial began improved their scores on a measure of exercise capacity — the timed 25-foot walk test — by 20 percent or more. And two patients who had been unable to walk when the study began were able to complete the walk test with assistive devices.
Patients who responded to the treatment improved their disability scores by 0.5 to 2.0 EDSS points
The stem cell treatment improved the bladder function of half the patients with a problem. Some were able to stop taking their bladder medications.
There were no serious adverse effects associated with the therapy. About 85 percent of the patients experienced headaches and fever in the first 24 hours after the treatment, which doctors managed with standard medications.
The treatment consisted of three injections of stem cells derived from the patients, administered three months apart. Patients received antibiotics to reduce the risk of infection.
Researchers used fresh cells rather than cells preserved by refrigeration. This may have contributed to the good results, they said.
“The protocol we created allowed for delivery of these stem cells within 30 minutes of harvesting” them, Dr. Violaine Harris, a senior research scientist at the Tisch center, said in a news release.
The Phase 1 results “justify the initiation of a planned FDA-approved Phase 2 trial in a larger group of patients,” said Dr. Saud A. Sadiq, the Tisch center’s director and senior author of the study.
“We anticipate that these novel studies may form the therapeutic basis of reversing disability in patients with MS, and if successful, these studies could have positive implications for treating other neurological diseases,” Sadiq added.
The Phase 2 trial (NCT03355365) is recruiting about 50 patients with primary progressive or secondary progressive MS. Patients must have an EDSS between 3 and 6.5. For additional information, visit the trial registry webpage.
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What Vitamin D Could Do for MS Patients

In this video from RxWikiTV, learn why a daily dose of vitamin D can do the body good, and that may be especially true for patients with multiple sclerosis (MS).
“These results are exciting, as vitamin D has the potential to be an inexpensive, safe and convenient treatment for people with MS,” said lead study author Peter A. Calabresi, MD, director of the Multiple Sclerosis Center at Johns Hopkins University, in a press release.
Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
CLICK HERE to watch Video and Read More



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Deep-brain Stimulation May Offer Way of Treating Fatigue in MS Patients, Pilot Study Finds

deep-brain stimulationDeep-brain stimulation, a non-invasive way of targeting neurons in the cortex, can significantly ease symptoms of fatigue in multiple sclerosis patients, research drawn from a clinical trial suggests.
Up to 90 percent of MS patients are believed to experience severe fatigue, a type of mental and physical exhaustion that can have a serious impact on a person’s work and social life. Because treatment options are limited for these patients, researchers are looking at deep-brain stimulation as a way to potentially alleviate this limiting condition.
Researchers at the NeuroCure Clinical Research Center in Germany conducted a pilot Phase 1/2a clinical trial to evaluate a technique developed by Brainsway, called deep transcranial magnetic stimulation and using a specifically developed H-coil that is capable of stimulating brain regions up to three times deeper than "figure-of-eight coils" used in standard TMS, the study states.
Areas in the brain's cortex are thought to play a key role in MS-related fatigue.
dTMS is a type of non-invasive stimulation that activates deep-brain structures through the use of electromagnetic fields that either excite or inhibit neurons. The approach is being increasingly used to diagnose and treat a range of neurological and psychiatric disorders.
To evaluate the safety and potential of repetitive H-coil dTMS as a treatment, researchers led by Friedemann Paul began by assessing the severity of MS-associated symptoms using a standardized survey and the fatigue severity scale. Twenty-seven of the 28 treated patients had FSS scores of 4.0 or more at the study's start; FSS ranks fatigue on a scale from 1 to 7.
The clinical study enrolled 33 participants, but five left early because of mild side effects that included headaches or facial/scalp discomfort. The remaining 28 received either the dTMS treatment — one group to the prefrontal cortex, another to the motor cortex — or a sham procedure three times a week for six weeks. The treatment involved a stimulation H-coil being placed above the patient’s head, which generated a magnetic field to influence nerve activity and neural circuits in the brain.
The combination H-coil plus dTMS was found to significantly reduced fatigue symptoms — especially in the study arm given motor cortex stimulation — with the treatment reducing FSS by a median of 1.0 point, which was sustained during follow-up. Among patients whose treatment was to the motor cortex, the median post-treatment drop in FSS was 1.74 compared to study start.
The treatment was found to be safe and well-tolerated in all MS patients, including those who left the study early. "We observed no serious side effects in patients treated with dTMS, and it is therefore worth stressing the tolerability of this noninvasive electrophysiological technique," said Paul, the study's principal investigator, in a press release.
The team is planning to further studies with a larger number of participants to better evaluate H-coil dTMS as a treatment for MS patients — for both fatigue and depression.
"While the results are promising, they have to be interpreted with caution, given the small sample size and the exploratory nature of the study and of the efficacy analysis," the researchers conclude. Still, "in light of the safety and tolerability of rTMS [repetitive TMS] treatment in MS-associated fatigue, our study strongly suggests further investigating its potential therapeutic efficacy and the underlying mechanisms."

Read on »



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MS may be a transmissible protein misfolding disorder, study suggests

REPORTING FROM ACTRIMS FORUM 2018
– Multiple sclerosis appears to be a transmissible protein misfolding disorder like Alzheimer’s and Parkinson’s diseases, results of a new study suggest. MS may even be caused by prions, potentially putting it into the same category as Creutzfeldt-Jakob disease.
Researchers don’t think MS is contagious between humans. But their findings in mice do suggest that the disease is transmissible from “a seed of protein misfolding,” Shigeki Tsutsui, DVM, PhD, of the University of Calgary (Alta.), said in an interview in advance of his presentation at the meeting held by the Americas Committee for Treatment and Research in Multiple Sclerosis.
Dr. Shigeki Tsutsui, research assistant professor in clinical neuroscience at the University of Calgary, Alberta
Dr. Shigeki Tsutsui
According to Dr. Tsutsui, the study is rooted in the MS origin theory that some factor causes damage in the central nervous system and triggers a secondary autoimmune response that sparks the disease.

“The next question is: ‘What is actually causing primary damage?’ ” he said. “Our hypothesis is that it’s protein misfolding. If protein misfolding targets the central neuron cells, then those damaged cells release a kind of a trigger to start an immune response.”
This isn’t an unusual concept. Protein misfolding is believed to cause several chronic neurodegenerative diseases, including Parkinson’s, Alzheimer’s, and amyotrophic lateral sclerosis, Dr. Tsutsui said.
The researchers focused on the potential transmissibility of human prion protein “since we thought that the prion protein might be the candidate causing the MS,” he said.
Prion diseases are extremely rare and often deadly. They appear when normal cellular prion proteins are induced to misfold when they come in contact with infectious agents known as prions.

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Study identifies characteristics that may constitute the MS prodrome


REPORTING FROM ACTRIMS FORUM 2018
– Compared with controls, patients who developed MS were more frequently admitted to the hospital or visited a physician for problems related to the nervous system, sensory organs, musculoskeletal system, and genitourinary system in the 5 years prior to MS onset, a multicenter matched cohort study found.
“People are seeking help for different conditions that are most likely related to their MS,” one of the study authors, Elaine Kingwell, PhD, said in an interview at the meeting held by the Americas Committee for Treatment and Research in Multiple Sclerosis. “It suggests there could be opportunity to recognize and possibly diagnose and treat MS earlier.”
Dr. Elaine Kingwell, an epidemiologist in the department of neurology at the University of British Columbia, VancouverDoug Brunk/Frontline Medical News
Dr. Elaine Kingwell
In a previously published study (Lancet Neurol. 2017;16[6]:445-51) led by Helen Tremlett, PhD, and first author Jose Wijnands, PhD, the team found increased health care utilization in people with MS across all health sectors – physician, hospital, and pharmacy (prescriptions filled).
For the current study, the team set out to identify early signs and symptoms that could define the MS prodrome. “We wanted to know why people went to the hospital, why people went to their physician, what kind of drugs they were prescribed, and what kind of specialists they saw,” explained Dr. Kingwell, an epidemiologist in the department of neurology at the University of British Columbia, Vancouver.


The researchers used health administrative and MS-specific data from four Canadian provinces to conduct a multicenter matched cohort study. Individuals were required to be in the province from 5 years pre-index date, measured as either the first demyelinating event in health administrative data or MS onset as determined by the treating neurologist, until the MS cases’ third demyelinating claim or diagnosis date. The potential for a prodromal period was examined in the 5 years pre-index date, and outcomes of interest were number of physician and hospital encounters per ICD-10 chapter, number of physician encounters per physician specialty, and percentage of people with one or more filled prescription per drug class.
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Third course of Alemtuzumab (LEMTRADA) can improve MS outcomes

Key clinical point: Patients who experience relapse of MS after alemtuzumab therapy may benefit from additional therapy.

Major finding: The annual relapse rate significantly decreased following a third course of alemtuzumab, from 0.85 in the 12 months prior to the third course to 0.20 in the 12 months after (P less than .0001).

Study details: An extension study of the CARE-MS II trial involving 393 of the original study participants.

Disclosures: Sanofi and Bayer HealthCare Pharmaceuticals supported the study. Dr. Bass reported that she is a principal investigator, speaker, and member of the advisory board for Sanofi Genzyme.

Source: Bass A et al. ACTRIMS Forum 2018 Poster P035.

REPORTING FROM ACTRIMS FORUM 2018

 – Approximately 30% of people with active multiple sclerosis who initially responded well to two courses of alemtuzumab in the CARE-MS II trial experience relapse or MRI activity over time. But investigators set out to determine whether retreatment with a subsequent course of alemtuzumab is worthwhile.
“What we found is, after the third course, they continued to do well again – at this point for an average of another 3-4 years,” Ann D. Bass, MD, said in an interview at the meeting, held by the Americas Committee for Treatment and Research in Multiple Sclerosis.
Dr. Ann D. Bass of the Neurology Center of San Antonio
Dr. Ann D. Bass
“The take-home message is if they do need to be retreated after those two courses, it doesn’t [necessarily] mean they are a treatment failure. Give them another chance and see if they will do well with a third course, which is what they did,” said Dr. Bass, of the Neurology Center of San Antonio.
Through year 6 of an extension study with 393 of the original CARE-MS II trial participants, 45% received one or more additional courses of alemtuzumab. Participants were required to wait 12 months or more after completion of the two initial courses of therapy. This figure includes 30% who received a third course of alemtuzumab, 12% who received a fourth course, and 2% and 1% who received a fifth or sixth course, respectively.
“The average time until they needed a third course was 2.5 years after the second course; so they didn’t need it right away,” Dr. Bass said. “The majority, even at 6 years, did not need to have a third course.”


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MS Views and News provides Multiple Sclerosis education, information, resources and services that will benefit many affected by MS. 
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First Steps: Confessions of an HSCT ( Hematopoietic stem cell transplant ) Survivor

First Steps: Confessions of an HSCT Survivor

 
Confessions? Survivor? Oh puh-leeze. So melodramatic, Dave. I know, right? But when I was preparing to get an autologous hematopoietic stem cell transplant (HSCT) in 2010 for my aggressive multiple sclerosis, I really could have used an insider’s look as to what I was getting myself into. I was part of the HALT-MS clinical trial sponsored in part by the National Institutes of Health, and I’ll say straight away that it saved my life. But it was so new that I had few resources and experiences to lean on. Here are just a few lessons learned, and some personal confessions, after going through a stem cell transplant– complete with high-dose chemotherapy and a lengthy hospital stay– for my ornery MS. Part one of this series is about the first steps to consider before undergoing HSCT.

Researching HSCT is, well, complicated

Before you pursue this path of treatment for your multiple sclerosis, a little research is in order. Okay, a lot of research. Today you can find fan sites galore with all sorts of advice on HSCT. And like most fan sites, they are predictably rah-rah with little balance for the “maybe-don’t-do-that” side. The information can be helpful, but take it with a grain of NaCl, as people don’t tend to boast about failed treatments. I recommend reviewing past research (I’ve posted all HSCT abstracts from the past 15 years on the forum at ActiveMSers) and sticking to reputable, unbiased websites. One last thing: HSCT is not “stem cell therapy,” which typically does not use chemo or involve a hospital stay and has little research to back up its effectiveness.

READ MORE


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MS Views and News is MAKING an IMPACT for those, affected by Multiple Sclerosis
MS Views and News provides Multiple Sclerosis education, information, resources and services that will benefit many affected by MS. 
SUBSCRIBE to our MS Learning Channel on YouTube: www.youtube.com/msviewsandnews
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