In this edition of eMS News
December 28, 2011
ECTRIMS 2011-Part II: Fingolimod, JC Virus, Laquinimode, Teriflunomide
Book Review: Multiple Sclerosis: The Questions You Have - The Answers You Need
Outdoors: MS and Skiing
Tools for Caregivers
Events and Educational Seminars
Resources

AN IMPORTANT MESSAGE FROM THE EXECUTIVE DIRECTOR

Dear Friend, 

It’s a great privilege to work at an organization that I know really makes a difference and is changing the way we think about and treat people living with multiple sclerosis.

I want to invite you to join me in my work by helping us raise the funding we need to lead the quest to defeat MS. You can donate online today. It's safe and secure, and only takes a moment. Show your support of the Rocky Mountain MS Center and donate today.

Breaking News

ECTRIMS 2011-Part II
Dr. Tim Vollmer, Medical Director of the Rocky Mountain MS Center

This is the second part of a two part series exploring the exciting research reports that came out of the 2011 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).

To read the first issue, click here.

Fingolimod (Gilenya®)

Fingolimod is a once-daily pill for reducing the number of relapses in people with relapsing forms of MS. Its mechanism of action is unknown, although it may work by reducing the number of circulating lymphocytes (a type of white blood cell), leading to reduced migration of white blood cells into the central nervous system.

Novartis presented data from 13 abstracts on fingolimod at ECTRIMS.  Data highlights include:

Despite previous MS disease-modifying treatment, in RRMS patients with high disease activity the following results were reported:

• 0.5 mg of Fingolimod significantly reduced annualized relapse rates (ARR) by up to 71%, compared to interferon beta-1a IM and placebo
• The relative reduction of ARR ranged from 61%, compared to interferon beta-1a in the TRANSFORMS trial, to 62%-71% compared to placebo in the FREEDOMS trial.

Despite treatment with interferon beta in MS in patients with high disease activity, and in patients with rapidly evolving severe relapsing-remitting MS, the following results were reported:

• 0.5 mg of fingolimod reduced the rate of brain atrophy, or brain volume loss, compared to interferon beta 1a IM over 12 months, regardless of disease activity prior to the Phase III TRANSFORMS study.

JC Virus

Natalizumab (Tysabri) therapy for MS carries a risk of progressive multifocal leukoencephalopathy (PML), a serious brain infection caused by reactivation of JC virus (JCV). JCV can be tested through a simple blood test, which registers anti-JCV antibodies if the virus is present.

Data presented at ECTRIMS by Biogen evaluated the prevalence of anti-JCV antibodies in patients from Europe, Canada, and Australia. At the time of the report, 10 countries had enrolled patients. Antibody prevalence differed significantly by country ranging from 48.0% (United Kingdom) to 66.7% (The Netherlands). Prevalence of anti-JCV antibodies also increased significantly with age, and was lower in females than in males (55.4% vs 60.8%.

They have also reported that no patient that tested negative for JCV antibody has developed PML.  This suggests the risk of PML with a negative test for the JCV antibody is less than 1 in 10,000.

Laquinimod

Laquinimod is an experimental immunomodulator developed by Active Biotech and Teva. It is currently being investigated as an oral treatment for multiple sclerosis (MS).

Although the phase III BRAVO trial's primary efficacy endpoint did not demonstrate a statistically significant treatment effect of laquinimod  over placebo, it did show a strong trend for treatment effect that matches that seen in the Allegro study, reported Timothy Vollmer, MD, of the University of Colorado in Denver. The drug was also clearly helpful in reducing the progression of disability and brain atrophy, which are arguably the issues that matter most to patients, said to Vollmer.

Vollmer reports that laquinimod appears to act primarily within the central nervous system to inhibit astrocyte activity and thereby reduce demyelination and neuronal loss, rather than by targeting peripheral immune cells as many other MS treatments do. As a result, a greater effect against neurodegeneration and disability, as opposed to acute attacks, is not surprising with the drug, he suggested.

"I think the future of MS therapy probably will be combination therapy, as in other fields," Vollmer said. Because laquinimod "is not a primary immunosuppressant," he added, it might produce "an additive and possibly a synergistic effect" with other drugs.

Teriflunomide

Teriflunomide is an experimental oral drug for multiple sclerosis and was investigated in the Phase III clinical trial TEMSO as a medication for MS. The study was completed in July 2010 and 2-year results were positive.

Researchers at ECTRIMS reported that teriflunomide improved cognitive performance and reduced relapse rates in patients with relapsing forms of multiple sclerosis.

For the study, patients with relapsing MS were randomized to either placebo or once-daily teriflunomide at 7 mg or 14 mg for 108 weeks. The primary objective was to evaluate the effect of teriflunomide on annualized relapse rate. Treatment effects on disability progression and MRI activity were assessed as secondary endpoints.

Both doses showed about a 31% reduction, with a little bit more MRI activity improvement with the higher dose, according to lead author Aaron Miller, MD, of Mount Sinai School of Medicine, New York, New York.

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Book Review
Multiple Sclerosis: The Questions You Have - The Answers You Need

Fifth Edition
By Rosalind C. Kalb, PhD
Reviewed by Alys Novak

Filled with information for those newly diagnosed to those considering long-term  care, this 400-page treasure does indeed seem to answer any question that someone living with MS, family/friends, healthcare providers, others with chronic illnesses will find useful.  Since it is designed to be a reference/resource, this would be a great addition to your personal library, and you are always welcome to come and review it at the Rocky Mountain MS Center.

Each chapter is authored by an expert, but written in everyday language.  Example:  The chapter on “Partnering with an MS Nurse” explains that “A primary goal of nursing care in MS  is to help people learn effective, preventive self-management in order to control minor problems before they became major ones,” with the chapter going on to cover such topics as bladder and bowel function, skin care, etc.

Sample chapter titles: “The Role of Physical Therapy,” “The Role of Occupational Therapy,” “Considering Options for Managing Relapses and the Disease Course,” and “Managing the Insurance Maze.”

The book uses a simple Q&A that is somewhat unusual. Questions posed by people living with MS are set out from the rest of the text in boldface and make it easy to find exactly what you are looking for.  Example questions:  “Is there anything I can do to prevent an exacerbation?”  Or “What is a physiatrist?”

Extra-added attractions are: a glossary; a list of medications commonly used in MS; recommended additional readings; and an excellent list of resources.

This book is in the Resource Center’s library collection of classic references at the Rocky Mountain MS Center.  To peruse or borrow the book, just visit the Center at 8845 Wagner Street in Westminster. Purchase at:

http://www.demoshealth.com/prod.aspx?prod_id=9781936303168

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Outdoors
Winter Skiing

Breckenridge Outdoor Education Center (BOEC) is accepting applications now for its winter ski trip for adults with MS!

Adventures Within – Come be Active while Discovering your Inner Strengths.
March 3-7, 2012 – Includes 3 full days of adaptive skiing and snowboarding.

“Being the first time in a BOEC program, we were not sure what to expect.  We can truly say, that what we experienced we would have never expected! Your staff, the program structure, accommodations, and food were of high caliber.  More importantly, the joy and confidence that the program provided someone who had not skied since 2004 due to MS, was a life changing experience.” ~ Past participant.

Please call or email the BOEC for details and to ask about scholarships.

www.boec.org
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
1-800-383-2632 ext.16 

In partnership with the Rocky Mountain MS Center.

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Caregivers
Powerful Tools for Caregivers Class Starts in January, 2012.

Powerful Tools for Caregivers is an educational program designed to help family caregivers take care of themselves while caring for a relative or friend. This 6-week program will give you the tools to communicate effectively, reduce negative thoughts and feelings as well as problem-solve.

The class will meet at the Rocky Mountain MS Center/KADEP every Tuesday night at 6:00 PM to 7:30 PM for six weeks in January and February. The fee for the class is $25. If interested, please call Chris Dunbar at (303) 433-6887 x131.

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Events and Educational Seminars
To see our full calendar of events, please click HERE or go to www.mscenter.org.

Educational Events
The 2012 Educational Calendar has been finalized! On the roster for this year:

• Conversations with Dr. Vollmer: held every other month around Colorado.
• MS 101: held the third Monday of every month.
• Legal Issues and MS: March 3, at the Aurora Summit Event Center.
• Gadgets, Gizmos, and Strategies: November 3, at the MS Center in Westminster.
• Research seminars: April 14 in South Denver, and October 6 in North Denver.

And new additions to the calendar:

• Powerful Tools for Caregivers: a six-week series starting in January.
• Managing MS Symptoms and Maximizing Wellness: May 12, in North Denver/Loveland, and September 15 in South Denver/DTC area.

Click HERE for a current calendar of events.

Learn more or register at www.mscenter.org or email name and number attending to Juanita McConkey at  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

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