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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, April 25, 2020

Sanofi brain-penetrant BTK inhibitor significantly reduced disease activity in Phase 2 trial in relapsing multiple sclerosis

PRESS RELEASES    April 23 2020

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Sanofi brain-penetrant BTK inhibitor significantly reduced disease activity in Phase 2 trial in Relapsing multiple sclerosis

  • Primary and secondary objectives were met with 85% or greater relative reduction achieved in the number of new gadolinium-enhancing T1 and new or enlarging T2 hyperintense lesions
  • No new safety signals identified  
  • Sanofi’s BTK inhibitor will potentially be first disease-modifying therapy to address sources of multiple sclerosis (MS) damage in the brain
  • Sanofi to initiate four Phase 3 clinical trials in relapsing and progressive forms of MS

PARIS – April 23, 2020 – Sanofi’s investigational BTK (Bruton's tyrosine kinase) inhibitor, an oral, brain-penetrant, selective small molecule achieved both the primary and secondary endpoints in a Phase 2b trial evaluating efficacy and safety in participants with relapsing forms of multiple sclerosis. The BTK inhibitor (SAR442168) significantly reduced disease activity associated with multiple sclerosis (MS) as measured by magnetic resonance imaging (MRI).
                
The Phase 2 study was designed to assess the dose-response relationship after 12 weeks of treatment with SAR442168, by measuring the number of new brain lesions on MRI.  The study evaluated four doses ranging from 5mg – 60mg after 12 weeks and used placebo data obtained at four weeks. In the primary objective measuring the number of new Gd-enhancing T1 hyperintense lesions, a multiple comparison procedure with modeling was applied to the dose-response data, revealing the exponential model provided the best fit (p=0.03). The treatment effect of SAR442168 at the 60mg dose was 85% relative reduction of new Gd-enhancing T1 hyperintense lesions. For the secondary objective measuring the number of new or enlarging T2 hyperintense lesions, the linear model was the best fit (p<0.0001), and compared to placebo, treatment with SAR442168 60mg resulted in an 89% relative reduction.
The BTK inhibitor modulates both adaptive (B-cell activation) and innate (CNS microglial cells) immune cells thought to be linked to neuroinflammation and neurodegeneration in the brain and spinal cord, the clinical significance of which is under investigation. 
“The results of this study give hope that SAR442168 may become an important treatment for relapsing MS,” said Daniel Reich, MD, PhD, Senior Investigator at the National Institutes of Health, Chief of the Translational Neuroradiology Section in the National Institute of Neurological Disorders and Stroke, and the academic principal investigator of the Phase 2b study. “In the context of compelling, emerging data about the role of the brain’s innate immune system in smoldering MS lesions, there is also good reason to believe that SAR442168 — due to its molecular mechanism of action and ability to cross the blood-brain barrier — may have additional effects that we need to study more deeply. In my view, it’s important to move forward with broad and innovative testing of this BTK inhibitor in phase 3 studies in MS.”
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What Can Reiki Do for Multiple Sclerosis?

 A noninvasive, complementary technique, Reiki helps some people with MS relax and feel better.

By: Kate Jackson   ~~~ Medically Reviewed by Samuel Mackenzie, MD, PhD
Last Updated: April 24, 2020


a woman with MS receiving Reiki treatment

Reiki aims to alter the flow of energy in and around the body.Getty Images

When Lisa S., 55, was diagnosed with multiple sclerosis (MS) in 2016, after decades of symptoms, she began taking a disease-modifying medication, which helped. But other medications prescribed for symptoms created new problems, and Lisa, a resident of Long Island, New York, decided to explore a more holistic approach to managing them.
She found yogameditationphysical therapy, and a “clean” diet helpful, and when a yoga instructor introduced her to Reiki — a Japanese energy healing technique — she was intrigued by the idea of a natural, noninvasive therapy that involved only touch and had no side effects.
Her first Reiki session was relaxing and gave her a feeling of peace and serenity — so much so that Lisa took a level 1 Reiki class so she could perform it on herself.
She now credits Reiki, in combination with other modalities, with helping her feel significantly better.  

What Is Reiki?
ike acupuncturetai chi, and qigong, Reiki — which means “universal life force energy” — aims to alter the flow of energy in and around the body, and is believed to facilitate relaxation, improve sleep, reduce anxiety and fatigue, and, perhaps, address more specific symptoms such as pain and spasticity.
The ability to perform Reiki is transferred from a master to a student in a process known as an attunement.
Beth Kane, a licensed clinical social worker and life coach in Point Pleasant, New Jersey, works frequently with people with chronic illnesses such as multiple sclerosis. Several years ago she began to explore Reiki. After taking the required classes and receiving the attunements, Kane became a Reiki master teacher and has been practicing for the past three years.
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Coronavirus and MS Reporting Database


COViMS (COVID-19 Infections in MS & Related Diseases) is a joint effort of the National MS SocietyConsortium of MS Centers and Multiple Sclerosis Society of Canada to capture information on outcomes of people with MS and other CNS demyelinating diseases (Neuromyelitis Optica, or MOG antibody disease) who have developed COVID-19.  Do they face special risks associated with COVID-19? Do certain disease modifying treatments incur special risks?  Together, the two organizations along with several independent experts have designed and launched this North American MS registry.

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Monocytes May Be Better, Safer Targets for MS Therapies, Study Suggests

 APRIL 23, 2020  BY INES MARTINS, PHD

Monocytes May Be Better, Safer Targets for MS Therapies, Study Suggests

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A subset of monocytes (a type of immune cells) that can infiltrate the central nervous system and drive nerve cell damage in multiple sclerosis (MS) may be a better target for preventing disease progression than the cells of the immune system that are currently targeted with MS therapies, a study in mice suggests.
Current MS treatments designed to dampen immune reactions against myelin — the protective coating of nerve cells that is lost in MS — are known to put patients at higher risk of infections. But researchers found that depleting this newly identified monocyte subset can reduce clinical signs of MS without affecting immune cells that fight off infections.
The immune system plays a critical role in MS onset and progression. In patients, immune cells travel from the blood into the brain, where they wrongly attack the myelin sheath that covers neurons, and initiate a set of inflammatory reactions that eventually cause nerve cells to die.
Immune B-cells and T-cells are seen as the major drivers of this inflammation, and most MS therapies are meant to target and eliminate these immune cells. But such approaches are not without side effects, as they also deplete patients from memory immune cells needed to fight foreign threats.
“Up until now, MS drugs have essentially targeted these T and B cells, both of which are part of the acquired immune system,” Alexander Mildner, the study’s co-senior author, said in a press release. Mildner is a scientist at the Max Delbrück Center for Molecular Medicine, Germany.
“But by attacking the acquired immune system, the MS drugs adversely affect the body’s immune memory, thus making patients more susceptible to infections in the long run,” Mildner said.
Knowing this, Mildner has been focusing on another subset of immune cells that is believed to also play a major part in MS progression: a subset of monocytes that produce the CCR2 protein.
“In an earlier study with a mouse model of MS, we were able to show that disease symptoms in the mice declined significantly within a few days after their monocytes were selectively destroyed by antibodies [against CCR2],” said Mildner. “Apparently, it is not only T and B cells that are involved in causing tissue damage in MS.”
Monocytes are immune cells that travel in the blood before migrating into tissues, where they can fight threats by engulfing them.
In MS, these cells also can participate in the process of inflammation by “eating” pieces of the central nervous system (CNS). But exactly what subsets of monocytes are entering the CNS and causing disease is largely unknown.


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How Monocytes Function in the Body

By Karen Raymaakers  - Updated on November 15, 2019
 Medically reviewed by Richard N. Fogoros, MD 


3D rendered Illustration of anatomically correct Monocyte immune system defense cells

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Monocytes are a type of white blood cell. Like other white blood cells, monocytes are important in the immune system’s ability to destroy invaders, but also in facilitating healing and repair. Monocytes are formed in the bone marrow and are released into peripheral blood, where they circulate for several days. They comprise about 5% to 10% of the circulating white blood cells in healthy individuals.
Monocytes are probably best known for their role in serving as something akin to reserve forces in the military. Some of them may be called up if needed, to form the precursors of two other types of white blood cells: tissue macrophages and dendritic cells. But monocytes also have other roles in infection and disease, some of which have nothing to do with tissue macrophages and dendritic cells.

What Healthy Monocytes Do in the Body

Until recently, the main role of monocytes was considered to be sensing the environment and replenishing the pool of tissue macrophages and dendritic cells, as needed.
Now it is known that different subsets of monocytes have different markers or protein tags on the outside, and these subsets may also behave differently.1 Three different kinds of human monocytes are now described:
  • Classical monocytes account for about 80 percent of the total monocyte population.
  • The remaining 20 percent can be classified by their protein tags as non-classical monocytes and intermediate monocytes
When it comes to the different kinds of monocytes and how they function in the immune system, researchers are still working out the details, and much more is currently known about mouse monocytes than human monocytes.
The terms “inflammatory” and “anti-inflammatory” are also used to describe human monocytes, based on the particular protein tags, or receptors, found on the outside of these cells. It is not yet certain in humans, however, what proportion of monocytes are mobile enough to go in and out of tissues, and evidence suggests there may be kinds of monocytes that can engulf and digest, or phagocytize, invaders but without actively promoting inflammation.

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Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course.

Abstract

Objectives: To provide clinicians who treat multiple sclerosis (MS) patients with evidence-based or expert opinion-based recommendations for promoting exercise and lifestyle physical activity across disability levels.
Methods: The National MS Society ("Society") convened clinical and research experts in the fields of MS, exercise, rehabilitation, and physical activity to (1) reach consensus on optimal exercise and lifestyle physical activity recommendations for individuals with MS at disability levels 0-9.0 on the Expanded Disability Status Scale (EDSS) and (2) identify and address barriers/facilitators for participation.
Recommendations: Based on current evidence and expert opinion, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers: Healthcare providers should endorse and promote the benefits/safety of exercise and lifestyle physical activity for every person with MS. Early evaluation by a physical or occupational therapist or exercise or sport scientist, experienced in MS (hereafter referred to as "specialists"), is recommended to establish an individualized exercise and/or lifestyle physical activity plan. Taking into account comorbidities and symptom fluctuations, healthcare providers should encourage ⩾150 min/week of exercise and/or ⩾150 min/week of lifestyle physical activity. Progress toward these targets should be gradual, based on the person's abilities, preferences, and safety. If disability increases and exercise/physical activity becomes more challenging, referrals to specialists are essential to ensure safe and appropriate prescriptions. When physical mobility is very limited, exercise should be facilitated by a trained assistant.

source:  PubMed article

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Thursday, April 23, 2020

Physical Therapy Telehealth with Gretchen Hawley, Physical Therapist & MS Specialist



CLICK HERE to see the Questions, showing below

What is Telehealth/Telemedicine?

What Are Common Reasons to Schedule a Telehealth PT Appointment?

Is it covered by my insurance?

Do I need to have a computer?

What Would We Do in a Telehealth Visit?

Do I Qualify / How Do I Get Started?

If you are not located in the above states, consider seeing if there is an MS specialized physical therapist in your area offering telehealth PT!

Additionally, The MSing Link is an Online MS Wellness Program that can help improve your strength, walking, fatigue, and so much more. You'll be sure to champion your MS symptoms!






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Tuesday, April 21, 2020

Tips to keep children healthy while school’s out

Based on available evidence, children do not appear to be at higher risk for COVID-19 than adults. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date.

Children may have mild symptoms

The symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally shown mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported.
It’s not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs. There is more to learn about how the disease impacts children. You can learn more about who is most at risk for health problems if they have COVID-19 infection on Are You at Higher Risk for Severe Illness.

Help stop the spread of COVID-19

Take steps to protect children and others from getting sick

Help stop the spread of COVID-19 by doing the same things everyone should do to stay healthy. Teach your children to do the same.
  • Clean hands often using soap and water or alcohol-based hand sanitizer.
  • Avoid people who are sick (coughing and sneezing).
  • Clean and disinfect high-touch surfaces daily in household common areas (like tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, and sinks).
  • Launder items including washable plush toys as needed. Follow the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting  and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.

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WHAT IS HSCT (hematopoietic stem cell transplant) ?

By Prof G

I seem to be spending a lot more clinic time explaining to my patients about HSCT. What is happening and why?

HSCT = hematopoietic stem cell transplant



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HSCT is simply a rebranding of bone marrow transplantation or BMT. BMT was the term we used when the stem cells had to be harvested by doing a bone marrow aspirates, i.e. a thick needle was inserted into the bone and the marrow sucked out under pressure. This procedure is painful and is done under sedation. I remember it very well when I was a houseman and junior medical registrar, or trainee, I worked on a haem-oncology unit and had to do this procedure. Fortunately, the haematologists have now developed an effective way of mobilising and harvesting stem cells from the blood without having to tap the bone marrow. This is done by giving a small dose of chemotherapy followed by growth factors so that the stem cells spillover from the bone marrow into the blood. These stem cells are harvested and frozen and can then be given after immunoablation therapy. Immunoablation therapy refers to chemotherapy to get rid of your immune cells. 

Please note that all that these stem cells do is allow you to receive more potent chemotherapy and work by allowing your bone marrow to recover more quickly. There is nothing magic about this; HSCT in the treatment of MS is simply used to speed up bone marrow recovery, nothing more and nothing less. More rapid bone marrow recovery makes BMT safer. 


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Registration Now Open for the CMSC VIRTUAL Patient program: Coming of Age with Multiple Sclerosis

and to register for this
VIRTUAL MEETING 





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PODCASTS on COVID-19 and MULTIPLE SCLEROSIS, by Barry Singer, MD

MS Living Well: Key Info from Multiple Sclerosis Experts -
Listen to these educational podcasts from MS Neurologist, Barry Singer, MD:

https://open.spotify.com/episode/7yK7STUZKKbPgSyTBFh5Zk?si=M4usS9ZqRs2-jQ5TIA1rsg

or: 

Apple Podcasts: https://podcasts.apple.com/us/podcast/ms-living-well/id1478469181 






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