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Friday, May 1, 2020

Best Life: Robotic exoskeleton helps multiple sclerosis patients walk again

Cleveland, Ohio (Ivanhoe Newswire) – Multiple sclerosis, it’s an unpredictable disease that disrupts the flow of information between the brain and the body, slowly robbing many patients of their ability to walk, causing tremors, muscle paralysis numbness, and weakness. Now, a robotic exoskeleton may help retrain the brain and keep MS patients up and walking.


Four days a week, this is where you will find Kathy Miska. “I have balance, I have buoyancy,” Miska said.
In the water, Miska can forget about her MS, a disease that claimed the life of her sister.
Miska told Ivanhoe, “Her last ten years of her life, she was a total vegetable. She couldn’t control her eyes. She couldn’t wiggle a finger.”
Now that same disease is slowly attacking Miska.
“It feels like you're giving up a little bit of your independence,” she described.
In a move to regain her mobility, she strapped on a robotic exoskeleton to retrain her brain and her body to walk normally again.

CLICK HERE to CONTINUE READING from WMC5


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Life in the Time of COVID-19 - from New Mobility Magazine (Life beyond wheels)

A trailblazing nurse wheels onto the front lines in New York City; an expectant mother with quadriplegia prepares for the arrival of twins; a quad quarantines on another continent; a vent user struggles to keep his “house of cards” support system from toppling; a longtime quad waits on indefinite hold for surgeries to restore function and ease pain; an Iowa resident tries to manage Medicaid privatization alongside anxiety and depression; and an outdoor enthusiast pretends his backyard is Yellowstone for an accessible #COVIDCampout. 

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It may be hard to remember, but six months ago no one had heard of social distancing, and the idea of the United States asking citizens to quarantine at home seemed like a laughable movie plot. 

Then a novel, highly-contagious virus ripped across the globe and changed everything forever. COVID-19 has affected everyone’s life to some degree, but its impact on our community has been disproportionately large. 

In this issue, we hear how the virus and all the disruptions that come with it have changed the lives of seven wheelchair users facing unique situations: a nurse, an active vent user, a traveler isolated in Argentina, a man struggling to find a caregiver, a mom-to-be, a quad awaiting key surgeries and an outdoor enthusiast. We’ve also compiled a selection of art from artists with disabilities, along with the latest medical information, news and resources to make this unprecedented and unsettling time more manageable.

Here are personal accounts of how wheelchair users across the country 
are dealing with the COVID-19 pandemic. 

Stories: Snapshots From Our Community
Facts: Disability-Specific Medical Info
Art: Images From Artists With Disabilities
Resources: Your Questions Answered




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Thursday, April 30, 2020

Ofatumumab (anti-CD20) Displays Superiority to Teriflunomide in Relapsing MS

Ofatumumab, Novartis’s fully human anti-CD20 monoclonal antibody, demonstrated a reduction in the risk of 3- and 6-month confirmed disability progression compared to teriflunomide in relapsing multiple sclerosis.

Dr Xavier MontalbanXavier Montalban, MD, PhD
New comparative data on ofatumumab, Novartis’ first fully human anti-CD20 monoclonal antibody with a monthly low-dose (20 mg) regimen, suggest that the therapy is superior in efficacy compared to teriflunomide (Aubagio; Sanofi) in treating patients with relapsing multiple sclerosis (MS).1

The data, which were accepted for presentation at the American Academy of Neurology (AAN) 2020 Annual Meeting, used pooled analysis from the phase 3 ASCLEPIOS I and II trials and suggest that ofatumumab significantly reduced the risk of 3- and 6-month confirmed disability progression (CDP) compared to teriflunomide, save for in a single subgroup of patients, Subset C.

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Siponimod Shows EDSS Subscale Benefits in Secondary Progressive MS

Novartis’s S1P receptor modulator siponimod (Mayzent) showed benefits in a number of patients with SPMS on the Motor Integration and Collateral subscales of the Expanded Disability Status Scale.By: Matt Hoffman
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These data were originally accepted for presentation at the canceled American Academy of Neurology (AAN) 2020 Annual Meeting.

“These data highlight the critical importance of early treatment intervention with a disease-modifying treatment, such as Mayzent, to ensure the best possible long-term outcomes for patients with MS who are experiencing progression,” Bruce Cree, MD, PhD, MAS, clinical research director, and George A. Zimmermann Endowed Professor in Multiple Sclerosis, UCSF School of Medicine, said in a statement. “It’s never too early to stay ahead of progression in multiple sclerosis, since the early identification of physical and cognitive changes—even subtle ones—can indicate MS disease progression and therefore allow for timely intervention.”

In total, the analysis included 1645 patients, of which 1099 were administered the sphingosine 1-phosphate (S1P) receptor modulator and 546 given placebo, and showed that significant treatment effects were detected over the 36-month study period for EDSS scores (P = .020), as well as both the MI (P = .014) and C (P = .021) subscales. The effect size favored siponimod from the 6-month mark and onward.

Continue reading


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The COVID-19 pandemic and the use of MS disease-modifying therapies

Maria was distraught after reading about the ‘potential’ epidemic, yet to happen, and the horror stories on Facebook needing reassurance and certainty about what she should do. She requested an urgent appointment to review her treatment plan. Maria was a 26-year-old woman with relapsing multiple sclerosis who had recently experienced brainstem relapse with double vision and ataxia despite treatment with pegylated interferon-beta for the last 18 months. A brain MRI performed one month prior had shown 16 new T2 lesions, four of which were enhancing. One of the enhancing lesions was at the pontomedullary junction and was certainly the cause of her relapse. Treatment was to be escalated to ocrelizumab with the first dose in a week's time. In view of the emerging coronavirus pandemic, she was questioning whether or not she should go ahead with ocrelizumab. This was despite only a handful of confirmed COVID-19 cases in the country and none in her town and region.


Continue to READ article here



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What Is COVID-19 Doing to the Brain?

Evidence is emerging that the virus that causes COVID-19 can invade the central nervous system.

 By Trevis Gleason For Life With Multiple Sclerosis   Last Updated: April 28, 2020



News that the novel coronavirus can affect the brain is alarming to those already living with neurological conditions

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The more people who are infected with the novel (new) coronavirus that causes COVID-19, the more we’re learning about its effects in the body.
Mounting evidence is showing that the virus, called SARS-CoV-2, is neurotropic, or capable of infecting nerve cells.
And while no one has suggested that such infections are more likely to occur in people who already have disease affecting their brains — such as multiple sclerosis (MS) — it’s hard for those of us already living with neurological conditions not to be anxious about the possible consequences such a viral invasion could have.

Reports of Neurologic Symptoms From China

As early as February 2020, the first reports out of Wuhan, China, where the first cases of what came to be known as COVID-19 were reported in December 2019, stated that “Compared with non-severe patients with COVID-19, severe patients commonly had neurologic symptoms manifested as acute cerebrovascular diseases, consciousness impairment, and skeletal muscle symptoms.”
Another study by Asian researchers, published in February, raises the question (but reached no conclusion) as to whether “potential [neuro]invasion of SARS-CoV-2 is partially responsible for the acute respiratory failure of patients with COVID-19.”

A Case of Encephalopathy Reported in Michigan

By the end of March, physicians from the Henry Ford Health System in Detroit reported in the journal Radiology the first case of COVID-19-associated acute necrotizing hemorrhagic encephalopathy, a rare central nervous system complication secondary to influenza or other viral infections that is characterized by altered mental status and seizures. It often leads to profound disability or death.
There are further reported cases of neurologic involvement by SARS-CoV-2, some of which appear to show receptors for the virus not only in the respiratory and digestive tracts but also in the blood-brain barrier and central nervous system nerve endings.

Numerous Neurological Features Observed in France

In a letter published on April 15 in the New England Journal of Medicine, doctors in Strasbourg, France, described the neurological features they observed in 58 patients admitted to the hospital because of acute respiratory distress syndrome (ARDS) due to COVID-19. They reported seeing encephalopathy (a general term for damage to the brain), prominent agitation and confusion, and corticospinal tract signs (a broad range of signs of central nervous system damage), as well as two ischemic strokes. They said it was unclear which if any of these were directly caused by the viral infection.

What This Might Mean for People With Multiple Sclerosis

While the level of central nervous system (CNS) involvement in COVID-19 is not fully understood, it is not lost on MS neurologists or patients that some of the disease-modifying therapies (DMT) used to treat multiple sclerosis “turn off” immune surveillance of the CNS.
In other words, if a person with MS were to acquire COVID-19, and their CNS were infiltrated by the virus, their prognosis would likely include major complications from the infection. We’ve seen such things before in the way of PML and other opportunistic infections allowed by some MS medications.
All the more reason for people with MS, particularly those on disease-modifying therapies associated with PML, to be extra vigilant about social distancing and self-isolation during this pandemic.
CONTINUE READING


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Wednesday, April 29, 2020

New 6-Year Data for Genentech’s Ocrevus (ocrelizumab) Show Earlier Treatment Initiation Nearly Halves Risk of Needing Walking Aid in Relapsing Multiple Sclerosis

Post-hoc analysis from 6 years of Phase III open-label extension studies showed Ocrevus treatment reduced the risk of needing a walking aid (EDSS≥6) by 49% in relapsing multiple sclerosis (RMS) patients compared with patients who switched from interferon beta-1a two years later –
– Separate analysis showed Ocrevus slowed thalamic volume loss in patients with RMS and primary progressive MS (PPMS) vs. interferon beta-1a and placebo, respectively –
– More than 150,000 people have been treated with Ocrevus globally, in clinical trial and real-world settings; data continue to show a consistent and favorable benefit-risk profile –

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South San Francisco, CA -- April 27, 2020 --
Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced new analyses of Phase III OPERA I and OPERA II studies, as well as the open-label extensions, showing that Ocrevus® (ocrelizumab) treatment reduced the risk of disease and disability progression in RMS and PPMS. These new analyses add additional evidence to the benefit-risk profile of Ocrevus, including the impact of MS on people’s daily lives. The data were selected for the 72nd American Academy of Neurology (AAN) Annual Meeting and will be made available online via virtual presentation in the coming weeks (in lieu of an in-person event).
“For people with MS, maintaining mobility for as long as possible is very important. We are encouraged by these new longer-term analyses showing that earlier initiation of Ocrevus treatment may reduce the risk of needing a walking aid by nearly 50 percent over six years,” said Levi Garraway, M.D., Ph.D., chief medical officer and head of Global Product Development. “Slowing MS progression earlier in the disease course – not just treating relapses – may bring additional clinically meaningful outcomes to people living with this disease.”
Effect of Ocrevus on disability progression and risk of needing a walking aid in patients with RMS
Earlier treatment with Ocrevus may delay the risk of needing a walking aid compared to those who switched from interferon beta-1a two years later in a new post-hoc analysis from the open-label extension of the Phase III OPERA studies in RMS. The risk was measured by the length of time until a person reached a score on the Expanded Disability Status Scale of 6 or greater (EDSS≥6) that was sustained for at least 48 weeks. People treated with Ocrevus had a 49% reduction in the risk of needing a walking aid compared to those that received interferon beta-1a over 6 years of study (4.3% vs. 7.2%*; p=0.0042). Safety profiles in the double-blind period and open-label extension were generally consistent.
Effect of Ocrevus on disease progression measured by thalamic atrophy
Ocrevus progressively slowed thalamic atrophy (as measured by change in thalamic volume) in patients with RMS or PPMS. Results from the double-blind periods of the Phase III OPERA I, OPERA II and ORATORIO studies showed significantly less thalamic atrophy compared with interferon beta-1a and placebo, respectively (both p<0.001). The thalamus is a deep grey matter structure within the brain that acts as a relay and integrative center, playing a key role in alertness, motor control and cognition, as well as sensory processing. It is affected by MS-related damage and its atrophy could be a useful marker of therapeutic efficacy.
With rapidly growing real-world experience and more than 150,000 patients treated globally, Ocrevus has twice-yearly (six-monthly) dosing and is the first and only therapy approved for RMS (including relapsing-remitting MS [RRMS] and active, or relapsing, secondary progressive MS [SPMS], in addition to clinically isolated syndrome in the U.S.) and PPMS. Ocrevus is approved in 90 countries across North America, South America, the Middle East, Eastern Europe, as well as in Australia, Switzerland and the European Union.


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Tuesday, April 28, 2020

What We Know About Multiple Sclerosis and COVID-19 - a Video by Stephen Krieger, MD

Stephen Krieger, MD
DISCLOSURES 
April 17, 2020





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COVID-19 and MS - Global Data Sharing Initiative

https://msdataalliance.com/covid-19/covid-19-and-ms-global-data-sharing-initiative/#lnk01

#DataSavesLives – #MSCOVID19

As the COVID-19 pandemic unfolds across the globe, the demand for data on the impact of the novel coronavirus on people with Multiple Sclerosis (MS) grows rapidly.
This information is crucial for people with MS and clinicians to make evidence-based decisions on how to manage their condition during the pandemic or in case of a COVID-19 infection.
MS Data Alliance and the MS International Federation have teamed up to set up a Global Data Sharing Initiative and are calling for individuals and organisations across the global MS movement to get involved.  Watch our animation.

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Follow our progress and sign up to our mailing list to receive regular updates on the initiative.



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Monday, April 27, 2020

OCREVUS® (ocrelizumab) Pregnancy Registry

OCREVUS® (ocrelizumab) Pregnancy Registry


Do you have multiple sclerosis (MS) and are you pregnant? Then you may be able to take part in a global registry of women with MS who are pregnant and either have or have not received OCREVUS® (ocrelizumab) during or within 6 months before their pregnancy.



About pregnancy and multiple sclerosis

The effects of a particular medicine on the health of an unborn baby are often unknown because pregnant women are not usually included in clinical research studies to test a potential new medicine. Pregnancy registries aim to collect information that could help women and their healthcare providers make more informed decisions about using a particular medicine during pregnancy in the future.


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Sunday, April 26, 2020

Starting Mayzent Early of Greater Benefit in SPMS, 5-Year Trial Data Show

APRIL 22, 2020 -  BY MARISA WEXLER, MS


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People with secondary progressive multiple sclerosis (SPMS) who began treatment with Mayzent early and continued its use for years are less likely to experience disability progression than those starting the medication later in their disease course, five-year data from the EXPAND study suggest.
Data from this same Phase 3 clinical trial further suggest that Mayzent can help preserve important tissues in the brain, delaying physical disability and slowing cognitive decline.
The findings were published in a supplementary issue of the journal Neurology following the cancellation of the 2020 American Academy of Neurology Annual Meeting due to the COVID-19 pandemic.
Mayzent (siponimod), developed by Novartis, is approved to treat active SPMS in both the United States and Europe. The oral therapy belongs to a class of medications called S1P receptor modulators. These work by ‘trapping’ immune cells in lymph nodes (immunological structures), which can limit the inflammation that causes nervous system damage in MS.
The Phase 3 EXPAND clinical trial (NCT01665144) is evaluating the safety and efficacy of Mayzent in people with SPMS. In the first part of this Novartis-sponsored study, participants were given either Mayzent or a placebo tablet for about three years. Results from this core part of the study, released in 2017, showed that Mayzent significantly slowed disability progression and cognitive decline compared to the placebo.
Click to continue reading from MS News Today


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