Promising new treatment approaches making news at the AAN meeting

Greetings from Philadelphia! You might remember that Philadelphia was our Nation’s capital during the revolutionary war. This week, the city of brotherly love is the capital of multiple sclerosis research as thousands of neurologists gather here to report their latest discoveries.

I have been impressed by both the number and the quality of studies on emerging therapies for MS being presented this week. One of these studies was the eagerly awaited clinical trial of the pregnancy hormone estriol combined with Copaxone in relapsing-remitting MS. This study was inspired by the observation that MS relapses are less frequent during the third trimester of pregnancy, a time when estriol is at its highest level. In this trial of 164 women, the investigators determined that pregnancy levels of estriol plus Copaxone reduced the rate of relapses after one-year by 47% compared to women taking Copaxone alone. There were also significant positive benefits observed in the scores of cognition tests. These positive effects were less significant in the second year of the study – the reasons why are not clear, but a more thorough analysis might reveal some answers.

The “hygiene hypothesis” proposes that the increased frequency of autoimmune diseases like MS in industrialized countries is due to a reduction in exposures to infectious bacteria, viruses and parasites. This hypothesis gave rise to a study reported by a team of investigators from the University of Wisconsin. Participants in this trial drank a sports drink laced with the eggs of a pig parasite called porcine whipworm every two weeks for ten months.

The number of active brain lesions detected at the end of the trial by MRI was moderately reduced by 34% compared to the number lesions detected at the beginning of the trial. Evidence was also presented that treatment could promote the activity of disease-suppressing white blood cells. This was a small trial and needs to be repeated in a larger number of participants before definite conclusions can be made. Imagine if we could treat MS with a sports drink?

Of all the many different industry sponsored clinical trials being presented this week, one that in particular intrigued me was a phase II trial testing a biological agent called Ofatumumab (who comes up with these names!) in MS. Ofatumumab targets a type of white blood cell called a B cell and is already approved for the treatment of B cell cancers. Previous studies suggest B cells play a role in MS disease activity, so getting rid of them may reduce relapses and help slow disease progression.

The study investigators reported a 65% reduction in the number of active brain lesions detected by MRI in the treated groups compared to the placebo groups – pretty impressive. These results add to previous studies with related agents and suggest targeting B cells is a very promising approach for treating MS.

Finally, something to keep your eye on for the future. IRX4204 is small molecule that selectively inhibits the activity of a receptor, or docking site, for a Vitamin A-like molecule called retinoic acid. Two studies presented this week suggest that IRX4204 may inhibit inflammatory responses and promote the repair of myelin, the nerve fiber casing that’s damaged by MS immune attacks. If true, this one-two punch could be a powerful combination that would both stop immune responses that lead to nervous system damage and also repair what has been lost. These are early stage animal model studies and must be followed up in people with MS before we get too excited, but I find the strategy to pursue agents with both anti-inflammatory and repair properties pretty exciting.

That’s it for now. I have to rush off to the next session (and a Philly cheesesteak sandwich). Stay tuned for more posts coming soon.

Tags Research, Treatment      8 Appreciate this
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Bruce

Bruce Bebo, PhD

Bruce Bebo, PhD, is Executive Vice President, Research at the National MS Society, and was previously a research immunologist focusing on the influence of sex hormones on MS. He is a driven and passionate Society volunteer, successful fundraiser and advocate, fueled in part by the fact that his mother had MS.

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    37 Comments

  • Avatar
    michellecorona519  Apr 30, 2014 3:45 PM
    NAMASTE, ! Keep up with your good works Dr, and how proud you're mother must be.
  • Eli Morowitz   Apr 30, 2014 3:47 PM
    I was with you Bruce, right up to the Philly cheese steak sandwich. Doesn't sound Swank Diet compatible.
  • John M.   Apr 30, 2014 3:57 PM
    So hope some of these are approved by the FDA/Trials. I took Copaxone (couldnt deal with the injections daily) and cant take Tysabri because of the jc virus. Hopefully this news will help benefit new MS patients and those struggling to cope. God bless us all and hope for a final cure one day.
  • Cheryl   Apr 30, 2014 3:59 PM
    Thank you for your post, i am currently going through the worst ms attack i ever had thanks for your knowledge of what options i might have
  • Cheryl Leek   Apr 30, 2014 4:44 PM
    Why did the trial just involve women? Am I to assume this product wouldn't be suitable for a male ms patient?
  • LYNNE HEAL   Apr 30, 2014 4:52 PM
    Way too many make profits, shares and commissions on MS drugs along with very high salarys. NO MS drug has ever cured MS and never will while all this has carried on for decades
  • Dana   Apr 30, 2014 5:12 PM
    Any thing reported on Lemtrada
  • LynnB   Apr 30, 2014 5:58 PM
    As a country that was finding cures for Polio, Chicken Poks, malaria on and on. We haven't cured a disease in decades because it's not profitable. I truly believe Diabetes could be cured as well as others. Can you imagine how many people would be out of work and big pharmacy would lose trillions in profit? We can't cure diseases it wouldn't be right, because if we did, no more fund raising to fund research, no more research more unemployment, more unemployment more healthy people that could different jobs, wouldn't that be horrible!
  • Cindy Dickerson   Apr 30, 2014 6:14 PM
    I was taking Copaxone for 8 months and they did another MRI and I have 3 new leisons so my Dr wants me to try Tedfidera. Do you have any information on that?
  • britta   Apr 30, 2014 6:50 PM
    Cindy, I was diagnosed in June of last year. I had 3 lesions on my brainy my doctor put me on copaxone from July till September. I didn't get any better. I got another MRI in September and I went from 3 to 15 and all were active. I switched doctors because he wouldn't listen to me. My new doctor put me on Tecfidera and I have improved SO much!!! It is doing wonders for the way the MS makese feel and with the relapses. I have not had a relapse in 7 months and it use to be on a regular basis. I found it to work for me. You can email me if you have anymore questions. B.fore1321@yahoo.com
  • Beth Paull Love   Apr 30, 2014 7:17 PM
    I was diagnosed in 1997. I'm fortunate that it is slowly progressing, if at all. But I was not and am not aware that disease modifying drugs could get rid of lesions. Am I misinformed?
  • koucla1  Apr 30, 2014 8:44 PM
    I am impressed to see that research in being pursued in the pregnancy hormone arena..During my one and only child bearing experience I felt great .. I am also pleased to see that another person is still living a LIFE even after having ms for forty plus years. I was diagnosed in 1975 and was not walking at the time. Now at 60,living independently, walking and doing what needs to be done..it is great to hear others are also overcoming our personal ms demons!
  • Steph   Apr 30, 2014 9:54 PM
    After 7 yrs with MS, with my first symptoms at age 16 and too many lesions to count, I know that a cure will be found. Soon? Maybe not. I worked in medical research before MS took away my cognitive abilities and know that research is not a quick fix to anything. It is long, difficult and time cosuming. Any medications that can help me to function day to day is a blessing!
  • Shannon flannery   May 1, 2014 11:50 AM
    The pig whip worm trail- I was the very first one to start taking that on the first phase of the trail. I really want this to get passed. I went from 14 active lesions down to 2 at the end. I was very impressed and anything is better then having to stick yourself with a needle.
  • Josh Carter   May 1, 2014 3:31 PM
    I have searched your website and find no mention of HSCT. This is a travesty that you don't let the MS community know about this treatment option. Yes, it's technically experimental but the fact that it's not on your website is really incompetent at best. It's not even listed as a treatment option yet many, many insurance companies pay for the procedure specifically for MS. This is very sad. I am beyond words.
  • Lorin Powell   May 1, 2014 4:09 PM
    Yes being pregnant helps MS symptoms! It is all about the increased bloodflow with that beautiful baby in there.
    My wife’s MS symptoms were a lot better during pregnancy also and then a year after our son was born her MS put her in a power chair.

    By the way Copaxone did nothing for my wife she was on it for over 5 years.
    But a 45 minute venoplasty sure made a big difference along with diet exercise and supplements.

    Lorin Powell
    Nanaimo BC
  • Tommt Cramer   May 1, 2014 7:42 PM
    My daughter developed MS at 28 years old. A very aggressive form. She is 40 years old now and in a wheel chair. She has been put into a health care facility because she needs care 24/7. Are any of the procedures mentioned above something I could look into for her in some way. It seems time is running out for her.
    thank you - Tommy C.
  • JamesO  May 2, 2014 1:09 PM
    Have you seen the artical ion web MD, it looks like its not just in philly they are showing off discoveries!

    https://www.webmdhealth.com/nl/nlv.aspx?id=81B715DAE524801D&s=23207
  • Joe Ceravolo   May 3, 2014 9:34 AM
    I have had MS for more than 10yrs, let me tell ya something folks. There will never be a cure of any kind for any disease - there is no money in it at all. A stockholder wants, stock price appreciation and dividend increases. There simply is no money in cure. A 75 yr old woman was told that buy the yr 2000 most disease's would be eradicated. Is this the 21st century?
  • Avatar
    Cristyne  May 3, 2014 6:00 PM
    Another glimmer of hope that will soon fade into the darkness as all the others have over the years. I started in the medical field as a volunteer at a hospital in 1983 became an EMT in 1990 & a Surgical Tech in 2010. I have seen all the aspects & then some. 3 back surgeries the last one being successful in 1999 only to get diagnosed with MS in 2000. I've been through the ringer with the meds. I've been on the oldest & "outdated" med for a few years IVIG & am now on Tecfidera with it. In the last 6 months I've been rapidly getting worse & not better. Big pharma is getting richer by the second while I struggle to pay for all the meds I'm on & stress over where I'm going to be living in a week or two. I know I'm not the only one & I know it doesn't help the MS but where & when does it all stop?
  • northwesternviews  May 19, 2014 2:49 PM
    Gives me a rush every time I read about research it gives me a rush every time
  • TINA   May 27, 2014 1:03 AM
    i AM LOOKING FOR SOMEONE TO EXPLAIN THE REASON WHY THEY TOLD ME THEY FOUND SOMETHING IN MY CSF FLUID TO INDICATE MS BUT IT IS NOT ENOUGH UNTIL THEY DO MRI OF BRAIN AND SPINE. i AM SO SICK AND THE WHOLE THING IS CONFUSING ME. CAN SOMEONE HELP?
    THANKS
  • capitolcarol   Jun 2, 2014 1:57 PM
    I Tina, I am just another MS sufferer. I know that they need to do a MRI of your brain and spine in order to see how many lesions. I have had several. The first one was just ghastly. Then the second one, a year later after I had been taking Tysbari infusions every 28 days showed that my lesions have stablized. Yeah, no new lesions. Carol
  • Carmelle Mills   Jun 3, 2014 2:06 PM
    I have been diagnosed with M.S. since Feb. 1981,diagnosed at the Health Sciences Centre in London, ON. Canada. I am ambulatory in my home without assistance. When I am outside of my home, I rely on either my walker or my cane to facilitate my walking experiences. I am still driving, and I am very grateful that it is" only" my "left" leg's inability to perform any action needed for the brake pedal or the gas. My body's 'right side' has "never" been affected by my MS, so over the last 33 years, I have gratefully been able to comfortably drive my vehicle. I am in my 67th year. I DO realize how fortunate I have been since my diagnosis in 1981. Since everyone's diagnosis with Multiple Sclerosis takes a unique course, my hope for everyone is that " a cure" is lurking in the near future and "Multiple Sclerosis" will be a disease of the past.
  • d-branch  Jun 7, 2014 7:09 PM
    I have just been diagnosed at age 50. I am very concerned. How long have I been living with this terrible disease? How many 2nd opinions should I get? Is Tecfidera a good drug?
  • Judith   Jun 8, 2014 10:27 AM
    I no longer want to know all the science behind MS. I spend too much time believing that I could cure or make it go away. Acceptance and deciding what can I do now to make my life more palatable was the question. I still have pain meds, etc but have greatly reduced their use by finding a plant based pain solution. Not just for sales but helping people has become my passion. For anyone interested and yes it has changed my life. http://judithlawrence.myplexusproducts.com/products/fast-relief-nerve-health-support 843-438-8102 Judith Lawrence
  • Jack B   Jun 17, 2014 9:29 AM
    My son was diagnosed with MS about 18 months ago. He is on Avonex drug once per week and it seems to have stabelized his progression. How do we sign up for some of the trials on the new drugs to reduce liasons and rebuild the nerve coatings? We have no idea all this was going on. Appreciate any comments back to my email address above.
  • Andrea   Jun 17, 2014 12:25 PM
    I was diagnosed in 2009 when I experienced vertigo. Went on Avonex 8 mos. later because I didn't believe my doc. Went on Tecfidera last July. I have just a few lesions and haven't had any new ones since being diagnosed. Spinal was clear. Don't experience many symptoms at all. A CT scan done before surgery showed possible calcification in the same area as lesion on my MRI. My doc had an MRA (MRI of blood vessels) to further investigate. Waiting to hear back from him, but radiology report said cavernous malformation in that same area. ??? That can produce the same symptoms as MS. I have questioned my MS diagnosis from day one, and may have been right all along. Getting a second opinion, too, as so many other conditions mimic MS. Will be interesting to find out what's really been going on!
  • Sherri   Jun 18, 2014 10:09 AM
    I was diagnosed at the age of 45 and will turn 50 in a month. My first dr. was concerned with my age, went for a second opinion and was told the later the diagnosis the better the prognosis. I haven't had a relapse in 5 yrs. I exercise and keep doing the things I have always done. Some days I feel like I've been run over by a truck but I get up get moving and it gets better. I know so far I'm a lucky one. I've been on Copaxone the entire time and as much as I hate the shots it's working for me so won't switch. I love that the new dosage is 3 times a week instead of 7.
  • stevenlabrat  Jun 18, 2014 11:14 AM
    I was a participant in an experiment that was an effort to build in me a new antibody. The experiment started in 1970 when I was 1 year of age. The experiment lasted until 1989 when I was 19 years of age. I was exposed to countless viruses and radiation. This research took place at the Denver V.A. hospital. I am 45 years of age today, with no M.S. symptoms. In theory my developing immune system could have built a new antibody capable of helping to fend of immune related illnesses. I am hoping that the M.S. community will help me see how successful this research was. See my profile. Pass the word. thank you!!
  • neurocuro  Jun 23, 2014 6:16 AM
    Does vitamin D help people who have MS? We are seeking the community's input to help determine this for all.

    https://www.surveymonkey.com/s/neurocuroVitDMS
  • Rebecca Wallace   Jun 26, 2014 12:53 AM
    I will follow the trials involving the pregnancy hormone estriol being my daughter was diagnosed
  • Rebecca   Jun 26, 2014 1:16 AM
    I will closely follow the trials involving the pregnancy hormone estriol. When my daughter was first diagnosed with MS at age 26 my suspicions increased about her use of the Arena ( a levonorgestrel releasing hormone)which is implanted in your uterus. It was there for 1 year prior to her diagnosis.
    There has been no evidence supporting my theory and neurologist are not interested in considering this factor. Is the estriol hormone somehow related to levonorgestrel releasing hormone, I ask myself and could it decrease the levels of estriol in your body? If anyone was using the Arena birth control when diagnosed with MS, please correspond. Maybe it would take us one step closer to finding a cure.
  • Rebecca   Jun 26, 2014 4:28 AM
    I'm sorry in regards to the previous comment ; the birth control is "Mirena" not Arena.
  • Avatar
    shellybel456  Jul 8, 2014 4:17 PM
    Techfidera has made huge difference in my life but not everything works for everyone why the more they find things that help others the better :)
  • ingagirl  Jul 11, 2014 12:41 PM
    Good afternoon,

    My name is Lyndsie and I work for Elliott Benson Research. I am contacting you this afternoon regarding a paid study we are conducting for residents of San Francisco who have been diagnosed with Multiple Sclerosis.

    We are looking for men and women over the age of 18 who do use an injectable therapy to treat their MS. The topic of the study is on different MS treatment options and how they have been evolving over time.

    This study is being conducted in San Francisco, CA on Monday, July 28th, Tuesday, July 29th, Wednesday, July 30th or Thursday, July 31st. We have several different times available to help accommodate busy schedules. For 1 hour of their time they will receive an incentive of $100.

    I am hoping you can forward this to the appropriate personnel or department who can help with recruiting MS patients. If anyone is interested in participating, please have them give me a call at 916.325.1670 and if you have any questions or would like some additional information, please do not hesitate to call. I look forward to hearing from you. Thank you for your time and help in this matter.

    Warm Regards,
    Lyndsie Ingebretsen
  • Light   Jul 25, 2014 10:08 PM
    We are going to completely destroy you and your re*****tion Mr. Bruce Bebo. MS is caused by a selenium deficiency and many of you already know this. Using the 90 Essential Nutrients will cure it completely. Your in for a world of hurt for hiding the truth. Prepare for the light, it's gonna hit you when you least expect it you greedy demon lord.