Progressive MS: A Key Topic at MSParis2017

Greetings from MSParis2017, the name for this year’s joint ACTRIMS/ECTRIMS (American/European Committee for Treatment and Research in MS) meeting held in Paris, France this week. The content of the meeting is online, and we’ve also created a web hub for MSPARIS2017 to help others keep up with the news.
 
Today, there was an exciting announcement of top-line results from a clinical trial of ibudilast in people with either primary progressive or secondary progressive MS. Ibudilast is an oral therapy, and I’m proud the Society helped fund this trial. Investigators reported that ibudilast reduced brain shrinkage (atrophy), which has been linked to disability. I’m looking forward to hearing additional details about this study during a presentation on Saturday, and especially what plans might be underway for further testing.

It’s been amazing for me to see the research community focus on progressive MS–ways to stop it and reverse the damage. I may be biased, but I think this is due in part to the activities of the International Progressive MS Alliance, the first global MS research initiative focused on progressive MS, which I am involved with as a staff lead for the National MS Society.

For the second year in a row, Alliance activities were the focus of a scientific session. This time, the leaders of the three Collaborative Research Networks, funded by the Alliance, shared information with all attendees at ECTRIMS. They were also involved in a terrific webinar.
 
Based on what I’ve heard so far this week at MSParis2017 (and we’re just at the beginning of the meeting), efforts to repair myelin, the nerve insulation that’s damaged by MS, are gaining more momentum. You may have heard that there are clinical trials right now that are testing ways to repair myelin. But research is also blossoming around how the brain repairs itself, and there might be things we can do to encourage that natural regrowth. A whole “Hot Topics” session at the conference focused on how brain activity might influence brain repair and rewiring.
 
Researchers from Paris explained that after the nerve wire (axon) is stripped of myelin, there’s a chance that immature myelin-making cells (oligodendrocytes, everybody’s favorite word) in the brain will repair it. But investigators are now finding that these cells are more likely to rebuild myelin on axons that show electrical activity. To make a long story short, they used a lab model to stimulate bare axons and found that this led to better myelin repair (Abstract 157).
 
Along the same lines, researchers from Milan, Italy discussed how brain-stimulating approaches, like repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have been used to treat some symptoms like depression and pain. But based on a growing body of brain science, it’s possible that combining these kinds of external stimulators with things like brain exercises (think memory or other challenging games) and rehabilitation may help rewire the brain and improve function. There’s a lot to figure out yet, but I think these approaches open new possibilities for restoring function (Abstract 159).
 
There’s emerging evidence that people can take steps to reduce–at least somewhat–their risks of disease worsening. A past NIH-funded clinical trial called CombiRx is still yielding some important information since it tracked people for up to 7 years. More than 800 participants filled out smoking surveys at the start of the study, and researchers looked for any links between smoking status and MS disease activity. They found that current smokers were more likely to experience relapses and disease progression than those who never smoked or who quit (Abstract P410).

Here's another: I attended a compelling presentation today based on a large-scale patient registry called MSBase, adding to evidence that being on a disease-modifying therapy early and consistently delayed the transition to secondary progressive MS (Abstract #128).

There will be more blogging on what people can do right now to maximize their health–especially the next blog coming from MSPARIS2017. Stay tuned!
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Douglas

Douglas Landsman, PhD

Dr. Douglas Landsman is Associate Vice President, Biomedical Research at the National MS Society. He leads the biomedical research and fellowship/faculty award programs, and plays a key role in the International Progressive MS Alliance. He has a long-standing interest in nerve-muscle interaction and developing strategies for promoting nervous system repair after disease or injury.

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    6 Comments

  • Tremica   Nov 3, 2017 7:16 AM
    How do I get information about the next MSParis event? I would love to go to something like this.
  • merlin leine   Nov 16, 2017 2:06 PM
    Is there sòmething new for primary progressive MS ? I was diagnosed in 2001 I am on Ocrevus now with the VÀ and are hoping for results but so far nothing.I am 66 years old and running out of time,thank you Merlin Leine
  • Irene   Nov 17, 2017 7:36 AM
    I am thrilled that there is so much impetus in gaining knowledge about MS, specifically Progressive MS with which I was diagnosed last year. Any news about the clinical trials on high dose biotin?
  • Robert Foyder   Nov 28, 2017 2:00 PM
    I am a Multiple Sclerosis Patient with a current diagnosis of Secondary Progressive.
    With each breakthrough, I still have questions concerning side effects.I have one brother, one sister with a diagnosis of Secondary Multiple Sclerosis...in a family where 3 out of four siblings have MS.
    In the case of my siblings, the side effects of the many first medications, taken infusions, pills, and injections apparently caused other medical problems with heart muscle, kidneys, and liver.
    In my recent situation, I was a participant in a Clinical trial for BaclofenER ( a once a day tablet) Paradox, the results so successful that the trial was ended , submitted to the process FDA& the medication was denied to the trial subjects.
    In my skepticism, medicine is not a science, it is practice.
    The other factors are financial for individuals such as myself on Medicare with PartD, I have made a decision to do without. In the final analysis, my MS has not progressed to any great extent while others with access to any MS drug seem to progress.
    In conclusion, any medication is a "double-edged sword" as stated with every new biologic advertised in medical publication or TV Commercial.
  • susan hoffman   Nov 30, 2017 9:57 AM
    Our daughter, who lives in the Bay Area, has progressive MS. She has started on Ocrevus. She is declining fast. She needs a doctor who specializes in progressive disease. At UCSF she seems to slip through the communication slats. Can you suggest an adviser for her?
  • Caroline DiMatteo   Dec 1, 2017 7:28 PM
    I am 69 and was diagnosed with PPMS in 2001. I have had unfavorable reactions to all the medications especially Tysabri, which I took for 9 months, and which progressed my disability more in that short period of time than it did for the first eight years. Just wondering what the reviews are on the new med. for PPMS, if anyone has had any severe side effects. I am a little leery about taking anything new, after taking the Tysabri. I cannot afford any more adverse reactions.

    Thank you.