Last month neurologists from the Rocky Mountain MS Center joined 8,500 MS specialists who gathered in Boston to present findings on multiple sclerosis research. The Americas and European Committees for Treatment and Research in MS committees (ACTRIMS and ECTRIMS, respectively) are the world’s largest professional organizations dedicated to the understanding and treatment of multiple sclerosis.
When this conference first convened more than twenty years ago, only a few hundred people attended. The number of experts at this year’s conference is very encouraging because it demonstrates the increased energy, interest, and dedication worldwide that is directed toward treating, understanding, and finding a cure for multiple sclerosis.
The 1,000-plus research presentations focused on treatments — both disease modifying and restorative — and new understandings of the disease process. For the full list and links to presentations, you can visit the meeting website and view scientific summaries. Below are some of the research highlights from the conference:
Emerging Therapies: Results from phase 3 trial of Daclizumab (DAC HYP)
Many of the studies presented related to research on disease modifying treatments. Daclizumab (DAC HYP) is a monoclonal antibody that has been studied in MS since 1999. It was developed about 30 years ago as a potential treatment for T-cell leukemia and is currently used to prevent rejection in organ transplantation. Monoclonal antibodies are similar to the antibodies produced by our immune systems. Antibodies fight diseases by attaching to specific foreign proteins to inactivate them. For example, if you are exposed to a virus, your immune system will produce antibodies to that virus so your body can quickly neutralize it and you won’t get sick. A monoclonal antibody is produced in the lab and works by binding to a specific protein involved in a disease process to deplete or inactivate it. Daclizumab targets the immune attack in MS.
Because we already have some partially effective therapies for MS, in the Phase 3 trial daclizumab was compared with an existing therapy rather than a placebo. The fact that this drug was tested against another drug, and not a placebo, is significant because this demonstrates how effective the drug is compared to existing treatments, rather than how it compares to no treatment.
More than 1,800 participants with relapsing-remitting MS received either DAC HYP injected under the skin once every four weeks, or Avonex injected weekly, for 92 to 144 weeks. The annual relapse rate was reduced by 45% in the DAC HYP group compared with Avonex. MRI disease activity was reduced by 54%. The reduction of disability progression was not statistically significant. Serious infections, skin-related adverse events, and liver enzyme abnormalities were increased in the DAC HYP group. Biogen Idec and AbbVie plan to file for marketing approval in 2015.
CLICK HERE to read the abstract.
Understanding MS Progression: Comorbidities
Comorbidities are health conditions that can occur along with MS, such as hypertension, diabetes, or heart disease. As we’ve discussed in our recent issue of InforMS magazine, these comorbidities can play a significant role in MS disease progression – many things that strain the body also strain the brain. To add further affirmation to this connection, Dr. Ruth Ann Marrie (University of Manitoba) cited a 2010 study which examined nearly 9,000 people enrolled in the NARCOMS patient registry. The study found that these conditions were associated with a substantially increased risk of disability progression.
There were also presentations related to diet and MS as researchers explored links between dietary patterns and the risk of developing MS. Much remains inconclusive and unknown about these links. For example, in a study conducted by Dr. Dalia Rotstein (Harvard’s Brigham and Women’s Hospital, Boston) and colleagues evaluated dietary habits reported by women involved in the Nurses’ Health Study and evaluated the difference between women who developed MS and those who didn’t. When they examined five popular diets, like the Mediterranean diet, the researchers found none of them were associated with a lower risk of developing MS.
And just in case you needed another reason to quit smoking: studies also discussed the impact of smoking on the progression of MS. Earlier this year American Academy of Neurology researchers described the link between the lungs and the brain. They pointed out that lymphocytes (immune cells) in our lungs go directly to our brain, impacting the immune system and worsening the progression of MS. In that vein, Dr. Tomas Olsson (Karolinska Hospital, Stockholm, Sweden) at ECTRIMS-ACTRIMS presented findings that smoking also appears to increase the likelihood of developing neutralizing antibodies to natalizumab (Tysabri, Biogen). These neutralizing antibodies “cause the drug to have little, if any, therapeutic effect in MS.” More information on this particular study can be found here: http://www.medscape.com/viewarticle/832798
CLICK HERE to read the abstract about comorbidities.
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