Multiple Sclerosis Year in Review
Disease-Modifying Relapsing MS Treatments
<p>The FDA approved Plegridy (peginterferon beta-1a) and Lemtrada (alemtuzumab) as disease-modifying therapies for people with relapsing forms of MS. Plegridy is injected under the skin every two weeks and has been designed to lengthen the effects of interferon. </p> <p>Lemtrada is an intravenous infusion given for five consecutive days initially and again for three consecutive days one year later. With the addition of these two treatments, there are now 12 disease-modifying treatment options for those with relapsing MS.</p>
Statins for Secondary-Progressive MS
A phase II, placebo-controlled clinical trial has shown that high-dose oral simvastatin can be beneficial for those with secondary-progressive MS. The study involved 140 patients and showed that the medication, usually used to treat high cholesterol, slowed the rate of brain atrophy over a two-year period by 43% compared with the placebo group.
<p>An international team led by Harvard researchers found that serum vitamin D levels early in MS may predict future disease activity and progression. Patients with higher vitamin D levels at disease onset had reduced disease activity and progression, and those with lower levels saw more disease activity and progression.</p> <p>In other research, people who took cod liver oil (a source of vitamin D) at age 13 to 18 years had a 50% reduced risk of developing MS compared with those who took it at other ages, and those who never took it. </p>
A new study has built on previous research that suggested smoking can increase the risk of developing MS and influence disease progression. Researchers found that every year that passes after a patient stops smoking can reduce the risk of MS progression by as much as 5%.
<p>Researchers at the University of California at San Francisco have identified a group of compounds that may stimulate myelin repair. Using new nanofiber and micropillar technology, the researchers tested 1,000 different molecules for their ability to stimulate myelin re-growth, finding that eight of them, called anti-muscarinic compounds, were effective.</p> <p>In other research, the anti-LINGO monoclonal antibody BIIB033 (Biogen Idec) is also being investigated for myelin repair and has yielded no serious adverse effects in two, phase-I safety trials. A phase II trial for the treatment of relapsing MS is now underway.</p>
In women with MS, researchers found an area of the brain with reduced tissue volume. They also linked this reduction to increased levels of depression, particularly a kind involving mood. Depression is commonly experienced with MS, but scientists had not previously understood its biological basis.
About 70% of 1,300 patients with MS who participated in a sleep study reported having at least one sleep disorder, but only 12% had received a diagnosis or treatment for their condition. These included insomnia, obstructive sleep apnea, and restless leg syndrome, which researchers think may play a role in abnormal levels of fatigue. Identifying and treating sleep disorders in people with MS could greatly improve quality of life.
A pilot study found that a salsa dance program improved gait and balance in people with MS. The effects lasted three months after the four-week program had ended. The National MS Society has funded a larger study of dance as physical therapy for MS based on the promising results.
Adolescent obesity increases the risk of developing MS later in life, a study found. This risk is especially high in those who also have gene variants that control the immune system: specifically, the presence of HLADRB1*15 and/or the absence of HLA-A*02.
In 2014, significant research progress has been made towards the treatment and prevention of multiple sclerosis (MS). Among the advancements are new medications that have received FDA approval, treatments that have shown promise in clinical trials, and the identification of several new risk factors. View the slides to read more about some of the most important MS research findings of the year.
Neurology Advisor Articles
- Excess Abdominal Obesity Linked to Severe Disability in Multiple Sclerosis
- Change in Dietary Patterns Over 5 Years in Early Multiple Sclerosis
- High-Dose Biotin May Be an Effective Treatment for Progressive MS
- Biobank Data Suggest Vitamin D Reduces Risk for Multiple Sclerosis
- Poor Functional Outcomes Tied to Depressive Symptoms in Multiple Sclerosis
- Oxidized Low-Density Lipoprotein May Predict Risk for Recurrent Stroke
- Inappropriate Prescribing Protocols in Parkinson Disease
- Physical Activity Decreases Vascular Comorbidities in Multiple Sclerosis
- Review of Factors Impacting Sport-Related Concussion Headaches
- Congress Passes Bill to Fight Opioid Crisis