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AAN: Exercise Regimens Relieve Depression in MS Patients

SEATTLE, April 29 -- Exercise, especially when reinforced by telephone consultations, can help improve symptoms of major depression in patients with multiple sclerosis, researchers said here.

MS patients in a single-center study had significantly reduced depressive symptom scores compared with controls who did not exercise, Charles Bombardier, Ph.D., of the University of Washington, and colleagues reported at the American Academy of Neurology meeting.

Dr. Bombardier said that patients with MS are very interested in exercise to prevent deconditioning, "especially people with depression and MS."

Major depression is common in MS patients, but antidepressants are only modestly effective, with a 24% to 57% response rate, Dr. Bombardier said.

Dr. Bombardier said the type of exercise varied by patient. "We didn't have anyone lifting weights," he said, but some patients walked or performed moderate-intensity exercise.

Dr. Bombardier said that there was a trend for exercise to improve more in the treatment group than the control group, but it was not significant. He said the beneficial effects on the depression scales could have been mediated by other factors such as another type of nonspecific therapeutic relationship.

Still, the researchers said the intervention "is a promising approach for treating major depression in patients with MS who can walk but are not exercising regularly."

Dr. Bombardier noted that both MS and depression "contribute to deconditioning," and it is possible that patients may "feel better if they're able to do things they like," as a result of decreased depressive symptoms.

He added that future research should investigate potential biopsychosocial mediators of the antidepressant effects of the intervention. ......full report in MedPage Today



UPDATE: Novartis MS Pill Works, But Safety Concern Remains

ZURICH (Dow Jones)--Novartis AG (NVS) said Wednesday new study results showed its experimental multiple sclerosis pill FTY720 worked better than a rival drug, but also reported the death of a patient who had taken the drug, highlighting concerns about the drug's safety profile.

Novartis, based in Basel, said results from a new late-stage study showed that 80% to 83% of patients taking FTY720 remained free of relapses during the one-year study - compared to 69% of those who took Avonex. Biogen Idec's (BIIB) Avonex is the best-selling treatment for the disease.

Analysts have in the past expressed concerns over the general safety of FTY720, in particular about the seven cases of skin cancer compared to only one on Avonex. Many have therefore lowered their estimates of the drug's potential.

Such concerns were reinforced through Wednesday's press release, where Novartis reported that a patient who had discontinued FTY720 died a few months later from pneumonia related to a progressive neurological disease.

"A role for FTY720 could neither be confirmed nor excluded," Novartis said in a statement.
But the finding increases the risk that the drug, one of Novartis' most important new drugs in development, may not pass regulator's scrutiny. The company reiterated that it plans to file the MS pill for regulatory approval in Europe and the U.S. at the end of 2009. "What's troubling about today's announcement is that surrounding the good news is the report of a new neurological death, which occurred in February this year," said Carri Duncan, pharmaceutical analyst in Zurich with Swiss private bank Sal. Oppenheim, who has a neutral rating on the stock.
"We believe if such serious events prove to be linked to FTY720 treatment, it could have a deleterious [bad] effect on the regulatory assessment of the drug later this year," she added.
Multiple sclerosis, or MS, is a chronic disease for which no cure is available, and patients usually require lifelong treatment once diagnosed. Symptoms range from blurred vision to partial or complete paralysis. In its most common form, called relapsing-remitting MS, patients suffer acute attacks - called relapses - of neurological dysfunction followed by complete or incomplete remission in function.

The data was presented at the American Academy of Neurology congress in Seattle, WA.
At 0815 GMT, Novartis shares were up CHF0.32, or 0.8%, at CHF42.80. They have fallen around fallen 19% year-to-date and underperformed the European healthcare sector at large, which is down 10% so far in 2009.
Article in the Wall Street Journal



Novartis MS Pill Works Better Than Biogen's Avonex

ZURICH (Dow Jones)--Novartis AG (NVS) said Wednesday that new study results showed its experimental multiple sclerosis pill FTY720 worked better than Biogen Idec's (BIIB) Avonex, the leading current treatment for the disease, paving the way for filing the drug for marketing approval later this year.

Novartis, based in Basel, said results from a new late-stage study showed that 80% to 83% of patients taking FTY720 remained free of relapses during the one-year study - compared to 69% of those who took Avonex.

Analysts have in the past expressed concerns over the general safety of FTY720, in particular about the seven cases of skin cancer compared to only one on Avonex. Many have therefore lowered their estimates of the drug's potential. Citigroup expects FTY720 to generate around $620 million in annual sales in 2012.

Multiple sclerosis, or MS, is a chronic disease for which no cure is available, and patients usually require lifelong treatment once diagnosed. Symptoms range from blurred vision to partial or complete paralysis. In its most common form, called relapsing-remitting MS, patients suffer acute attacks - called relapses - of neurological dysfunction followed by complete or incomplete remission in function.

The data was presented at the American Academy of Neurology congress in Seattle, WA.
Novartis shares closed Tuesday at CHF42.46, having fallen 19% year-to-date. They've underperformed the European healthcare sector at large, which is down 10% so far in 2009.
Company Web Site:
Article in the Wall Street Journal



Star Supporters Back MS Week Research Call

An eclectic range of stars including Sir Chris Hoy, Professor Colin Pillinger, Lorraine Kelly and former Manchester United footballer Danny Wallace have signed up to a letter calling for more funding for multiple sclerosis (MS) research to mark the start of MS Week (27 April to 4 May).

The letter - backed by the MS Society and published in today's Daily Telegraph - draws attention to the devastating impact of MS and calls for greater funding for research. The MS Society is the UK's largest charitable funder of MS research and spent more than £7million on research last year.

The range of signatories shows the diversity of people affected by MS, ranging from Olympic and Paralympic Gold Medallists, planetary scientist Colin Pillinger (the man behind the Beagle 2 Mars lander) and Chris Donald, co-founder of Viz magazine. .....full report in Medical News today


MS Drug News, MS Risk Factors Create Headlines From American Academy Of Neurology Meeting This Week

The annual meeting of the American Academy of Neurology (AAN) is being held April 25th-May 2nd in Seattle. There will be hundreds of presentations related to MS, including news on MS drugs in the pipeline or now in use, as well as factors such as smoking that may increase the risk of getting MS.

As usual, the National MS Society plans to cover the most significant studies being presented there in a comprehensive summary that will be posted after the meeting has taken place.

In the meantime, the scientific abstracts presented at the meeting are available on the AAN's Web site.

full report in Medical News Today


Long-Term Study With COPAXONE(R) Indicated Protective Effect On Brain Tissue In Multiple Sclerosis Patients

New data presented provided evidence that long-term treatment with COPAXONE® (glatiramer acetate injection) may offer sustained protection from neuronal/axonal injury. This protective effect was reflected biologically by a significant increase in N-acetylaspartate (NAA), a specific marker of neuronal mitochondrial function, in treated versus non-treated relapsing-remitting multiple sclerosis (RRMS) patients. These six-year results augment previously published findings suggesting that treatment with COPAXONE® may provide a neuroprotective effect in RRMS patients1, 2.

The study, "Six-Year Prospective Multi-Voxel Brain MRS Study of Two Cohorts in RRMS To Examine the Effect of Glatiramer Acetate on Neuronal/Axonal Metabolic Injury," is the largest (n=46) and longest study of its kind to date. In the study, patients taking COPAXONE® for six years experienced an improvement in neuronal mitochodrial function, as quantified by an increase in neuronal NAA levels and evaluated by 1H- Magnetic Resonance Spectroscopy (1H-MRS). Decreased neuronal NAA levels are reflective of neuronal/axonal injury.

"The potential ability to prevent or repair brain tissue damage in RRMS patients is an important treatment consideration given the degenerative pathology of this life-long condition," said Omar Khan, M.D., Professor of Neurology, Director, Multiple Sclerosis Center, Wayne State University and lead investigator of the study. "These data further substantiate our previous research into the potential neuroprotective effect of COPAXONE®, as well as the use of NAA measures as a reliable marker for assessing a patient's disease progression and response to treatment."

Similar results were reported from a different study examining the effect of COPAXONE® in Clinically Isolated Syndrome (CIS) patients. The study demonstrated patients who received COPAXONE® improved in their cerebral neuroaxonal integrity relative to patients treated with placebo. Patients on placebo showed a decline in NAA consistent with that demonstrated in historical control studies. ...............full report in Medical News Today



AAN: Another Polyomavirus Appears Reactivated with Natalizumab

AAN: Another Polyomavirus Appears Reactivated with Natalizumab

By John Gever, Senior Editor, MedPage Today
Published: April 28, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
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SEATTLE, April 28 -- The JC polyomavirus responsible for progressive multifocal leukoencephalopathy (PML) may not be the only such virus reactivated by natalizumab (Tysabri).
In a study of 57 patients receiving natalizumab for relapsing-remitting multiple sclerosis, twelve (22%) saw reactivation of the BK polyomavirus, which can cause nephropathy and hemorrhagic cystitis, reported Roisin Lonergan, M.S., a neurology fellow at St. Vincent's Hospital in Dublin, Ireland.
No cases of clinical disease or other overt adverse effects were seen in the study, which began in January 2007, Dr. Lonergan said in a poster presentation here at the American Academy of Neurology's annual meeting.
Nevertheless, monitoring patients taking natalizumab for BK polyomavirus reactivation and for renal dysfunction may be warranted, she suggested.
The occurrence of three cases of PML, which is often fatal, forced natalizumab off the market in 2005, just a few months after its initial approval. Marketing resumed in June 2006 under a restricted-access program intended to prevent additional PML cases.
Natalizumab is a monoclonal antibody against the alpha4-integrin adhesion molecule. It is believed that this mechanism somehow allows latent infections with the JC polyomavirus, which are extremely common, to become active again.
But the JC virus responsible for PML is not the only common polyomavirus capable of causing significant illness, prompting the Irish study of possible BK virus reactivation.
Such reactivation has been seen in patients receiving kidney transplants and follow-up immunosuppressant treatment. Nephropathy caused by the virus is a frequent cause of graft failure in these patients.
Dr. Lonergan and colleagues prospectively evaluated 57 patients starting treatment with natalizumab.
They found BK virus in urine in three of 36 baseline samples prior to starting on the drug.
Subsequently, the virus was found in urine or blood samples in 12 patients, following a mean of 11.2 natalizumab doses (range 1 to 23).
The researchers also identified JC virus reactivation on one patient after a single dose. PML did not develop.
Nor did any cases of renal dysfunction occur, the researchers found. Renal profiles remained within normal limits in all patients.
Dr. Lonergan said the latter finding should be reassuring to patients on natalizumab therapy.
Absolute CD4- and CD8-positive cell counts did not decrease significantly overall with natalizumab.
However, four of the patients with BK virus reactivation showed transient reductions in CD4-positive cell counts shortly before the virus was detected in urine.
In three of these patients, moreover, a return of CD4-positive cell counts to baseline values paralleled suppression of BK virus replication.
Lily Jung, M.D., a neurologist at Swedish Neuroscience Institute in Seattle, who was not involved with the study, said the findings could be significant.
She noted that urinary tract infections are not uncommon in multiple sclerosis patients. But the possibility that blood in the urine might reflect hemorrhagic cystitis related to BK reactivation, rather than an ordinary urinary tract infection, is a concern.
"They get blood in their urine, and it's very easy to . . . say it's a UTI rather than a reactivation of the polyomavirus," Dr. Jung said.
But she noted that no actual cases have been seen yet, a point echoed by Giancarlo Comi, M.D., a neurologist at Hospital San Raffaele in Milan, Italy, who also was not involved with the study.
He said BK virus reactivation was "theoretically" a concern, but the lack of dysfunction seen in the Irish study suggested that clinicians need not worry about it for now.
"To link this to a new risk, to me, there is no reason [now]," Dr. Comi said.
On the other hand, he suggested the findings could be helpful to virologists in shedding light on the dynamics of polyomaviruses. full report in MedPage Today

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What's new for 'Multiple Sclerosis' in PubMed

Opportunistic infections and other risks with newer multiple sclerosis therapies. - The introduction of newer therapies for the treatment of multiple sclerosis has generated considerable optimism. That optimism has been tempered by the potential risks of these therapies, such as the risk for progressive multifocal leukoencephalopathy. A review of the possible causes of reactivation of JC virus in this population has illustrated the need to better understand the untoward effects of monoclonal antibody therapies and other immunomodulatory therapies currently being contemplated for use in multiple sclerosis. - Ann Neurol. 2009 Mar 19;65(4):367-377. [Epub ahead of print] in PubMed

Varicella zoster virus is not a disease-relevant antigen in multiple sclerosis. - VZV is not a disease-relevant antigen in MS. Ann Neurol 2009;65:474-479. in PubMed

[Stem cell therapy in multiple sclerosis : A clinical update.] - Promising results in an animal model of multiple sclerosis (MS; experimental autoimmune encephalomyelitis, EAE) have shown that immunosuppression followed by allogeneic bone marrow transplantation has the potential to significantly ameliorate the spontaneous course of the disease. - Z Rheumatol. 2009 Apr 29. [Epub ahead of print] in PubMed

Clinical implications of a possible role of vitamin D in multiple sclerosis. - From a purely medical point of view, vitamin D supplementation appears in this light to be unavoidable in order to improve the general state of these patients. Furthermore, it cannot currently be ruled out that this supplementation could also be neurologically beneficial. - J Neurol. 2009 Apr 28. [Epub ahead of print] in PubMed

Macrophages of multiple sclerosis patients display deficient SHP-1 expression and enhanced inflammatory phenotype. - Lab Invest. 2009 Apr 27. [Epub ahead of print] in PubMed

Retinopathy: an overlooked adverse effect of interferon-beta treatment of multiple sclerosis. - Therefore, IFN-retinopathy may be uncommon in MS, but neurologist should be mindful of this adverse effect and regularly check the fundus, particularly in patients with possible risk factor, diabetes mellitus. - Keio J Med. 2009 Mar;58(1):54-6. in PubMed

Control of visually guided saccades in multiple sclerosis: Disruption to higher-order processes. - These ocular motor characteristics demonstrate considerable sensitivity with respect to evaluating attentional deficits in MS, evident even in the absence of clinical signs of disease. Neuropsychologia. 2009 Jun;47(7):1647-1653. Epub 2009 Feb 7. in PubMed

[Cognitive evoked potentials in remitting-relapsing and benign forms of multiple sclerosis.] - The data obtained in this experiment confirm the presence of attentional impairment in patients with diverse forms of multiple sclerosis. The exclusive modulation of the P3 latency component suggests that the impairment in these patients, at the beginning of the disease, is localized at a central level of cognitive processing and is product of the demyelinating process. - Rev Neurol. 2009 May 1-15;48(9):453-8. in PubMed

Examining the link between information processing speed and executive functioning in multiple sclerosis. - This study reinforces the link between IPS and working memory in MS, and supports the suggestion that IPS is not a unitary construct. - Arch Clin Neuropsychol. 2009 Feb;24(1):47-58. Epub 2009 Mar 11. in PubMed

Multisequence-imaging protocols to detect cortical lesions of patients with multiple sclerosis: Observations from a post-mortem 3 Tesla imaging study. - J Neurol Sci. 2009 Apr 22. [Epub ahead of print] in PubMed

Drug rash with eosinophilia and systemic signs syndrome in a patient with multiple sclerosis. - We report a case of DRESS syndrome possibly associated with mitoxantrone in a patient with MS. - Clin Ther. 2009 Mar;31(3):580-4. in PubMed

Brain pathways of verbal working memory A lesion-function correlation study. - Our study provides direct evidence on the white matter pathways subserving verbal working memory in the human brain. - Neuroimage. 2009 Apr 22. [Epub ahead of print] in PubMed

Impact of sex steroids on neuroinflammatory processes and experimental multiple sclerosis. - Front Neuroendocrinol. 2009 Apr 22. [Epub ahead of print] in PubMed

Steroids and neuroprotection: new advances. - This special issue of Frontiers in Neuroendocrinology contains a collection of reviews of the most recent ideas and findings on these various aspects of sex steroid-dependent neuroprotection. - Front Neuroendocrinol. 2009 Apr 22. [Epub ahead of print] in PubMed

Multiplexing approaches for autoantibody profiling in multiple sclerosis. - Identification of MS-specific autoantibody specificities is important for the development of diagnostic and prognostic markers for MS. Moreover, it can provide more knowledge regarding underlying MS disease processes and novel therapeutic targets. -Autoimmun Rev. 2009 Feb 9. [Epub ahead of print] in PubMed

The relevance of vitamin D receptor gene polymorphisms for vitamin D research in multiple sclerosis. - In this concise review, we will discuss the mostly investigated genetic polymorphisms of the vitamin D receptor (VDR), and their consequences for VDR functionality and immune regulation. Next, we will discuss the association of these polymorphisms with MS, and their relation with vitamin D metabolism. - Autoimmun Rev. 2009 Feb 10. [Epub ahead of print] in PubMed

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MRI Data Showing TYSABRI® Promoted Remyelination Presented at the 61st Annual Meeting of the American Academy of Neurology

-- Additional data suggests improvement in TYSABRI patients across clinical and patient-reported outcomes --

SEATTLE--(BUSINESS WIRE)--Biogen Idec (NASDAQ: BIIB) and Elan Corporation, plc (NYSE: ELN) today announced results of a study demonstrating that TYSABRI® (natalizumab) promoted regeneration and stabilization of damage done to the myelin sheath, as measured by advanced MRI technology. Damage to the myelin sheath causes the symptoms of multiple sclerosis (MS). Additional posters will also be presented during the Congress highlighting the ability of TYSABRI, in some patients, to improve physical function and patient reported outcomes on cognition, quality of life, and fatigue. TYSABRI is the first approved MS therapy with reported data suggesting that some of the signs of disease progression can be stopped. The strong efficacy profile demonstrated in clinical trials is enhanced further from these data and may help redefine success in MS.

“What we have seen in these MRI data suggest that TYSABRI may have the capacity to repair and possibly restore some of the damaged myelin sheath that protects nerve fibers. Results from this study support the continued investigation of the potential effects of TYSABRI on this process,” said Robert Zivadinov, M.D., of the Jacobs Neurological Institute in Buffalo, N.Y., the lead investigator for the remyelination study.

“TYSABRI is changing the way neurologists and patients define success in the treatment of MS,” said Michael Panzara, M.D., M.P.H., vice president and chief medical officer of neurology, Biogen Idec. “These MRI data presented at AAN provide early evidence that TYSABRI may not just slow the progress of MS, but may also be able to reverse the damage inflicted by the disease.”

”Everyday, more patients understand that TYSABRI can represent a new way of looking at – and managing – their disease,” stated Carlos Paya, M.D., Ph.D., president, Elan Corporation. “These latest analyses further build on the impressive data we have seen to date with TYSABRI.”

TYSABRI helped stabilize and restore damage to the myelin sheath

The imaging study, which included a total of 110 subjects, used an advanced MRI technology called the Voxel-Wise MTR to measure lesions and normal brain tissue. The study showed that TYSABRI promoted remyelination when compared to those receiving interferon beta-1a IM and normal controls.

The effect of TYSABRI on lesions and NABT in relapsing MS was evaluated with a Voxel-Wise (VW) imaging method using magnetization transfer ratio (MTR). VWMTR is recognized as a powerful instrument for monitoring MS disease activity and effectiveness of therapeutic interventions in patients with MS.

In the study, 62 MS patients who received TYSABRI were followed for 12 months together with 26 MS patients who received interferon beta-1a IM and 22 age-matched and sex-matched normal controls. For each subject, baseline and follow-up MTR volume maps were placed in a common halfway-space. The resulting VW subtraction map was then enhanced via threshold-free cluster enhancement (TFCE) algorithm, and a significance threshold was determined based on subject-specific Monte Carlo simulation. Supra-threshold volumes (95th percentile) were quantified for both areas of increasing (remyelinating) and decreasing (demyelinating) MTR voxels, which represent a volume value.

There was no significant difference in decreasing VWMTR NABT volume over the follow-up between TYSABRI-treated and normal control groups. Relapsing-remitting patients on both therapies showed higher remyelination potential and less evident demyelination than relapsing secondary progressive patients. The volume of VWMTR changes in NABT (decreasing or increasing) was almost 3-5 times higher than the amount of changes observed for T2-lesion volume. This indicates that the VWMTR method might be a much more sensitive approach to capture demyelination/remyelination changes over time than the lesion-based volume measures.

The poster describing the study Natalizumab (Tysabri®) Promotes Remyelination in Patients with Multiple Sclerosis. A Voxel-Wise Magnetization Transfer Imaging Case-Control Study (P03.071) is available for viewing on Tuesday, April 28, 2009, at 4:00 p.m. PDT.

TYSABRI significantly increased the cumulative probability of achieving sustained improvement in disability in patients with relapsing MS

The poster describing the study Sustained Improvement in Physical Disability with Natalizumab in Patients with Relapsing Multiple Sclerosis (P06.131) will be available for viewing on Wednesday, April 29, 2009, at 4:00 p.m. PDT.

Data from this post-hoc analysis was previously presented at the 2008 World Congress on Treatment and Research in Multiple Sclerosis. The data showed TYSABRI produced significant results on the cumulative probability of sustained improvement in physical disability in those treated over two years compared with placebo. In patients with a baseline expanded disability status scale (EDSS) score ≥ 2.0, treatment with natalizumab significantly increased the probability of sustained improvement in disability by 69 percent relative to placebo. In the same patients, the probability of achieving sustained improvement was 29.6 percent with TYSABRI (n=417) compared with 18.7 percent with placebo (n=203) (p=0.006). In patients with an EDSS score ≥ 2.0 and highly active disease at baseline, the difference between groups was even greater, 35.5 percent for TYSABRI (n=103) and 15.4 percent for placebo (n=40) (p=0.045).

Patient-Reported Outcomes Study

In this study, patients with relapsing-remitting MS were asked after three months of treatment to rate their improvement, using validated outcomes tools. The posters presented at AAN show that overall, patients reported significant improvement in cognitive function, general and disease-specific health-related quality of life, and lower-levels of fatigue after the third infusion of TYSABRI. The ongoing one-year longitudinal study assesses health outcomes from the perspective of the patient before starting TYSABRI and at predetermined timepoints thereafter.

One of the posters, Early Effects of Natalizumab on Patient Reported Fatigue and Cognitive Function (P02.142) was made available for viewing on Tuesday, April 28 at 11:30 a.m. PDT and a second poster, Change in Health-Related Quality of Life in Multiple Sclerosis Patients Receiving Natalizumab (P05.144) will be available for viewing on Wednesday, April 29, 2009, at 11:30 a.m. PDT.

Story in CNNMoney



New Data Illustrate Novel Mechanism of Action of Laquinimod, an Oral Compound for the Treatment of Multiple Sclerosis

Teva Pharmaceutical Industries Ltd. (NASDAQ: TEVA) and Active Biotech (NASDAQ OMX NORDIC: ACTI) today announced results from several new clinical and preclinical studies providing further insight on the immunomodulatory mechanism of action (MOA) of laquinimod, a novel oral once-daily compound being developed for the treatment of relapsing-remitting multiple sclerosis (RRMS). Four sets of data being presented at the 61st Annual Meeting of the American Academy of Neurology (AAN) in Seattle stand to increase the understanding of how laquinimod may reduce multiple sclerosis (MS) activity and affect mechanisms related to disease pathology.

While research looking at the mechanism by which the compound exerts its clinical effect is ongoing, currently available data indicate that laquinimod impacts RRMS by modulating key processes of the immune system, and suggest an immunomodulating effect within the central nervous system (CNS).

“As we continue to study how laquinimod impacts multiple sclerosis, we remain encouraged by the potential of this oral candidate,” explains Scott Zamvil, M.D., Ph.D., Associate Professor, Department of Neurology, University of California, San Francisco. “Laquinimod, with a balanced safety and efficacy profile, may address a currently unmet medical need for patients seeking effective oral therapy for MS that is well tolerated and safe."

Laquinimod recently received Fast Track designation from the U.S. Food and Drug Administration (FDA), which may allow the drug to enter the market as soon as late 2011. Teva completed enrollment for the first of its two Phase III clinical trials for laquinimod (ALLEGRO) in November 2008, and the second global Phase III study (BRAVO) is on schedule to complete patient enrollment in the first half of 2009................full story in Genetic Engineering & Biotechnology News


With Aid of Drug Library, New Remedies From Old

Housed in a row of white freezers in a nondescript laboratory at the Johns Hopkins University School of Medicine in Baltimore are more than 3,000 of the estimated 10,000 drugs known to medicine. There is no sign on the door to indicate that this is perhaps the largest public drug library available to researchers interested in finding new uses for old and often forgotten drugs.

Already, researchers have used the library to discover that itraconazole, a drug used for decades to treat toenail fungus, may also inhibit the growth of some kinds of tumors and may forestall macular degeneration. Another drug, clofazimine, used more than a century ago to treat leprosy, may be effective against autoimmune disorders like multiple sclerosis and psoriasis.

“It takes 15 years and costs close to a billion dollars to develop a new drug,” said Jun O. Liu, professor of pharmacology and director of the Johns Hopkins Drug Library. “Why not start with compounds that already have proven safety and efficacy?”

He and his colleagues have been building the collection since 2002 and hope to have it complete by 2011. They acquire the drugs through donations, purchases and sometimes lab synthesis. And they will send researchers a complete set — minuscule amounts of every drug in the library — for $5,000, which covers the cost of shipping and replenishment.

Since the toenail and leprosy drugs are approved for use in the United States and are no longer under patent protection, clinical trials to test their new uses are either under way or close to regulatory approval, Dr. Liu said.

Drugs still under patent protection are more complicated; patent holders seldom allow independent research on alternative uses. “The drug companies haven’t been too keen on helping us,” Dr. Liu said.

There are other drug libraries, both commercial and noncommercial. Commercial suppliers offer considerably fewer drugs than Johns Hopkins (though they may have medicines it does not), and they charge much more. Noncommercial drug libraries include those at the National Institutes of Health; the University of California, San Francisco; and McMaster University in Hamilton, Ontario. But they will usually not send drugs to unaffiliated researchers. And like the commercial libraries, their holdings are smaller and composed largely of compounds from Hopkins.

Regardless of the source, researchers typically order copies of entire collections rather than individual drugs they think may work in their experiments.

“We’ve found drugs that are active in ways no one would have ever hypothesized,” said Marc G. Caron, a professor of cell biology at Duke who is using the Johns Hopkins library to find drugs that might quell the cravings of substance abusers.

Testing of these compounds has become much easier in recent years as a result of an automated technology called H.T.S., for high-throughput screening. The drugs are dissolved in a solution and stored in rectangular, compartmented plates reminiscent of ice trays; they can then be delivered to researchers for testing of their efficacy against various diseases, or disease mechanisms like inflammation.

Computerized droppers, plate agitators and microscope image readers can now accomplish in days what it once took bench scientists years to do.

Although H.T.S. has been around for at least a decade, it is just within the last five years that the technology has been widely available. Previously, only big pharmaceutical companies could afford to screen thousands of compounds; now more public and academic institutions are doing so, and their emphasis tends to be on rediscovering or tweaking the chemical structure of old drugs rather than developing new ones.

“The instrumentation to do sophisticated, large-scale screening of drugs has gotten significantly better and cheaper,” said Michelle Arkin, associate director of the Small Molecule Discovery Center at U.C. San Francisco.

Some institutions, like McMaster in Ontario and Rockefeller University in New York City, allow outside researchers to use their H.T.S. facilities for $10,000 to $20,000, depending on the complexity of the project.

Access to such facilities has increased demand for compounds, particularly already approved and off-patent drugs, to analyze. Johns Hopkins and commercial suppliers report a surge in orders over the last two years — because there are more H.T.S. laboratories, they said, and because of efforts to find cheaper therapies against third world scourges like malaria and tuberculosis.

“Old drugs are the low hanging fruit in terms of finding safe and inexpensive treatments for these diseases,” said Carl Nathan, chairman of microbiology at Weill Cornell Medical College in New York. Dr. Nathan receives plates of drugs from Johns Hopkins as well as commercial suppliers and does high-throughput screening at Rockefeller, which has a partnership with Weill.

“I’m addicted to it,” he said.
Story in the New York Times



What's new for 'Multiple Sclerosis' in Neurology CiteTrack: MS (in MEDLINE)

The relationship between handedness and risk of multiple sclerosis. - While the current results suggest that prenatal exposure to sex hormones may play a role in multiple sclerosis risk, direct examination of the relationship between in-utero hormone exposure and hand preference is necessary before any conclusions can be drawn. - Multiple Sclerosis, May 1, 2009; 15(5): 587-92. in HighWire Press

Past environmental sun exposure and risk of multiple sclerosis: a role for the Cdx-2 Vitamin D receptor variant in this interaction. - Multiple Sclerosis, April 21, 2009; . in HighWire Press

Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis. - Prospective studies are required to determine appropriate dosing regimen to achieve optimal levels in the majority of MS patients and to ascertain the safety, immunological response, and ultimately the clinical efficacy of vitamin D replacement therapy. - Multiple Sclerosis, April 21, 2009; in HighWire Press

Regulation of matrix metalloproteinases and their inhibitors by interferon-{beta}: a longitudinal study in multiple sclerosis patients. - ConclusionsThese data suggest that MMPs may differ in their expression levels in MS patients and that this group of enzymes is differentially regulated during the treatment with IFN-beta in MS for at least 6 months. - Multiple Sclerosis, April 21, 2009; . in HighWire Press

The search for responsive clinical endpoints in primary progressive multiple sclerosis. - Multiple Sclerosis, April 21, 2009; . in HighWire Press


Fat-Derived Stem Cells Might Treat MS

Small study suggests they inhibit runaway immune system response
SUNDAY, April 26 (HealthDay News) -- Stem cells taken from the fat tissue of people with multiple sclerosis (MS) may help treat the disease, suggests a preliminary study that included three patients.

The successful use of the stromal vascular fraction (SVF) cells in these patients shows that further clinical studies should be conducted into the use of SVF cells to treat multiple sclerosis and other autoimmune diseases, the researchers said.

"All three patients in our study showed dramatic improvement in their condition after the course of SVF therapy. While obviously no conclusions in terms of therapeutic efficacy can be drawn from these reports, this first clinical use of fat stem cells for treatment of MS supports further investigation into this very simple and easily-implementable treatment methodology," Dr. Boris Minev, division of neurosurgery at the University of California, San Diego, said in a news release.

"None of the presently available MS treatments selectively inhibit the immune attack against the nervous system, nor do they stimulate regeneration of previously damaged tissue. We've shown that SVF cells may fill this therapeutic gap," Minev said. - The study was published in the Journal of Translational Medicine.
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BioMS Medical obtains positive review for Phase III multiple sclerosis trial

Results from Maestro-01 expected in second half of 2009

BioMS Medical has reported that the independent data safety monitoring board for the company's pivotal Phase III Maestro-01 Canadian/European trial of dirucotide in patients with secondary progressive multiple sclerosis has completed a safety analysis and recommended that the trial continue as per the protocol.

Maestro-01 is a multi-center, double-blind, placebo-controlled trial designed to evaluate the safety and efficacy of dirucotide in patients with secondary progressive multiple sclerosis. The study is being conducted at 47 sites across Canada and nine countries in Europe and includes 611 patients being administered either dirucotide or placebo intravenously every six months for a period of two years.

The primary clinical endpoint for the trial is defined as a statistically and clinically significant increase in the time to progression of the disease, as measured by the expanded disability status scale, in patients with HLA-DR2 and/or HLA-DR4 immune response genes. Time to disease progression in patients with other HLA-DR types will be assessed separately as an exploratory arm of the same study.

This was the final scheduled review by the data safety monitoring board (DSMB) prior to the completion of Maestro-01. The purpose of the DSMB is to provide objective, independent safety monitoring of the trial. Results from Maestro-01 are expected in the second half of 2009.
Pharmaceutical Business Review


Reality show host welcomed in Plymouth

By Rusty Nixon Correspondent

PLYMOUTH — Bicyclists raced across Plymouth Sunday with reality show host Phil Keoghan for a reason.The star of CBS hit reality show “The Amazing Race” stopped in Plymouth as part of his bike across America to raise awareness and money to find a cure for multiple sclerosis.“My dad’s cousin has MS,” said Keoghan. “It’s a terrible, crazy disease, and the way he’s dealt with it is inspirational. He hosts a fishing show in New Zealand and he’s refused to give up. He’s a big burly man like my dad and now he hosts his show from a wheelchair. He refuses to quit.”

Keoghan became involved with raising money for the MS Society four years ago. His original goal was to come up with $250,000 for the charity on this ride. Having already surpassed that, the new goal for he and his father is half a million.

He’s also had his share of adventure on his ride.

“We had 60 mile per hour tail winds at one point,” he said. “I was riding at 57 miles per hour on a flat run. When I didn’t peddle I was running at 30 miles per hour. We had the opposite too. I was riding at 300 volts and was only doing six and a half miles per hour.”

Even a trip to the hospital didn’t stop Keoghan’s trip.

“I remember feeling horrible one day, really terrible, one of those days that you just don’t want to get up,” he said. “That day a young man with MS got out of bed for the first time in six months just to come and meet me. As bad as I felt, he feels that bad every day. That’s why I keep going.”

Fans across the country have kept up with his ride by logging on the Web site which has led to some interesting moments. “People can see exactly where we are on the site,” he said. “And they’ve literally been running out of their houses to wave as we go by.”

Keoghan’s ride is scheduled to end up in New York City on May 9.........story in the Pilot News


Magnetic Brain Stimulation for Cocaine Addiction, Multiple Sclerosis?

Brainsway Inc., a Jerusalem, Israel firm that develops deep transcranial magnetic stimulation (TMS) machines, has announced receiving approval from the US National Institute on Drug Abuse (NIDA) to conduct a trial of its product to test whether the system can be used to treat cocaine addicted patients. Additionally, the company plans to test its device in a Berlin hospital as a treatment option for people with symptomatic multiple sclerosis.

About TMS therapy from Brainsway:
Transcranial magnetic stimulation (TMS) is a noninvasive technique used to apply brief magnetic pulses to the brain. The pulses are administered by passing high currents through an electromagnetic coil placed adjacent to a patient's scalp. The pulses induce an electric field in the underlying brain tissue. When the induced field is above a certain threshold, and is directed in an appropriate orientation relative the brain's neuronal pathways, localized axonal depolarizations are produced, thus activating the neurons in the relevant brain structure...........

Deep TMS is a breakthrough in the search for a non-invasive approach for treating common brain disorders. Deep TMS uses a unique, patented coil design to produce directed electromagnetic fields that can induce excitation or inhibition of neurons deep inside the brain.

The treatment is non-invasive, with no significant side effects, no systemic effect (in contrast to drugs), and no need of hospitalization or anesthesia. .............Read the full story in medGadget



When Medical Bills Outpace Your Means, Seize Control Swiftly

MEDICAL bills have a way of piling up — especially when you’re sick or underinsured. Just ask Kirk Kupka, 48, and his wife, Susie, 53.

Mr. Kupka has multiple sclerosis. The Kupkas, who live in Lindstrom, Minn., have an annual income of $45,000 — a combination of her salary as an office manager and his disability payments.

More than 20 percent of that income goes toward health care. Their annual insurance premiums total $5,400, and then there’s the $4,000 Mr. Kupka spends on drugs, doctor’s visits and lab fees before he fulfills his policy’s deductible.

In the three years since Mr. Kupka’s disability forced him to stop working as a mental health therapist, he has accumulated $12,000 in debt.

“It’s frustrating,” he says. “We earn too much to qualify for state and county assistance, but not enough to stay ahead of the bills. I’ve thought maybe my wife and I should get divorced. But not only is it against our faith, it turns out it wouldn’t help.”

Medical debt can lead to drastic measures, forcing people to raid their 401(k)s, tap into home equity lines and, in some cases, declare bankruptcy. Surveys by the commonwealth Fund, a nonprofit health care research foundation, found that 41 percent of adults said they were struggling to pay their health care bills in 2007, up from 34 percent in 2005. That percentage is almost surely growing.

And as Mr. Kupka’s situation illustrates, it’s not just uninsured patients who rack up large bills. Nearly two-thirds of those with debt problems, according to Commonwealth, had health insurance.

But insurance covers less and less these days, as employers continue shifting more health care costs to their employees, and as consumers resort to lower-cost plans that come with high deductibles or less generous benefits.

“People who have been faithfully paying insurance premiums for years are coming in with medical bills they can’t pay,” said Gail Cunningham, a spokeswoman for the National Foundation for Credit Counseling, an umbrella group for services that help consumers cope with debt.

But if you’re having trouble paying your medical bills, you’re not helpless, either. There are ways to reduce, or at least more effectively manage, medical debt. full story with tips in The New York Times


Heavy NSAID Use Linked to Higher Dementia Risk

LITTLE FALLS, N.J., April 22 -- Healthy older adults who were heavy users of nonsteroidal anti-inflammatory drugs (NSAIDS) were more likely to develop dementia than those who were not, researchers found.

Among patients 65 and older, heavy NSAID users were 66% more likely to develop dementia and 57% more likely to develop Alzheimer's, John Breitner, M.D., M.P.H., of the University of Washington School of Medicine in Seattle, and colleagues reported online in Neurology.
The findings contradict previous studies that found a reduction in the risk of dementia with use of NSAIDs. (See: NSAID Use Linked to Reduced Alzheimer's Risk)

The researchers said the discrepancy might arise from the fact that participants in their study were older than those in other studies. ....full report in MedPage Today


Adult Stem Cells May Help Treat Multiple Sclerosis

LITTLE FALLS, N.J., April 24 -- Adult stem cells taken from a patient's own fat tissue may help reverse the clinical manifestations of multiple sclerosis, a preliminary study suggested.

Three patients with multiple sclerosis who received infusions of cells from the stromal vascular fraction of adipose tissue -- which contains mesenchymal stem cells -- all had improvements in their conditions, Boris Minev, M.D., of the University of California San Diego, and colleagues reported online in the Journal of Translational Medicine. ......full story in MedPage Today


Teva To Present New Data On Its Innovative Therapies For Multiple Sclerosis And Parkinson's Disease At The Upcoming 2009 American Academy Of Neurology

Teva Pharmaceutical Industries Ltd. (NASDAQ: TEVA) announced that several new studies addressing the Company's innovative central nervous system (CNS) portfolio will be presented at the 61st Annual American Academy of Neurology meeting in Seattle starting April 28, 2009. .....full report in Medical News Today


Fat Tissue Stem Cells Offer Hope For Multiple Sclerosis Treatment

A preliminary study on the use of stem cells obtained from a patient's own adipose tissue in the treatment of multiple sclerosis (MS) has shown promising results. The three case studies, described in BioMed Central's open access Journal of Translational Medicine support further clinical evaluation of stromal vascular fraction (SVF) cells in MS and other autoimmune conditions.

Thomas Ichim, from Medistem Inc., and Dr. Boris Minev, from the Division of Neurosurgery, University of California San Diego, worked with a team of researchers to demonstrate the possible effectiveness of SVF cells in MS treatment. Minev said, "All three patients in our study showed dramatic improvement in their condition after the course of SVF therapy. While obviously no conclusions in terms of therapeutic efficacy can be drawn from these reports, this first clinical use of fat stem cells for treatment of MS supports further investigations into this very simple and easily-implementable treatment methodology". .......full report in Medical News Today


Glasgow GP Brings First LDN Conference To Europe To Help Raise Awareness Of Treatment For Autoimmune Diseases

Some of the world's leading medical speakers and practitioners are flying into Glasgow this week as the first European Low Dose Naltrexone (LDN) Conference comes to Scotland. Held on Saturday 25th April at the Western Lecture Theatre at University of Glasgow, the conference will attract leading medical professionals and patients who are interested in the use of the drug LDN in the treatment of many different autoimmune diseases - including multiple sclerosis, Crohn's disease and chronic fatigue syndrome or ME. .......full report in Medical News Today


What's new for 'Multiple Sclerosis' in PubMed

Allogeneic mesenchymal stem cells transplantation in treatment of multiple sclerosis. - Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system. Umbilical cord derived mesenchymal stem cells are immunosuppressive. We transplanted mesenchymal stem cells in a patient with refractory progressive MS, and the disease course was stabilized after the transplantation. We postulate that mesenchymal stem cells have a potent immunosuppressive effect in vivo. - Mult Scler. 2009 May;15(5):644-6. in PubMed

Association between MRI parameters and the MS severity scale: a 12 year follow-up study. - MRI measures of axonal loss are associated with higher overall disease severity in MS patients. - Mult Scler. 2009 May;15(5):632-7. in PubMed

The relationship between handedness and risk of multiple sclerosis. - This study suggests a modest increase in risk of multiple sclerosis among left-handed women. Further investigation of this relationship is suggested in other populations including both males and females. While the current results suggest that prenatal exposure to sex hormones may play a role in multiple sclerosis risk, direct examination of the relationship between in-utero hormone exposure and hand preference is necessary before any conclusions can be drawn. - Mult Scler. 2009 May;15(5):587-92. in PubMed

Proof of concept studies for tissue-protective agents in multiple sclerosis. - Mult Scler. 2009 May;15(5):542-546. in PubMed

Molecular network of the comprehensive multiple sclerosis brain-lesion proteome. - Mult Scler. 2009 May;15(5):531-41. in PubMed

Fatigue in multiple sclerosis. - Fatigue affects up to 90% of MS patients and can significantly impair function, quality of life, and interaction with family and friends. The common causes of fatigue and effective interventions and treatments are reviewed in this article. - Phys Med Rehabil Clin N Am. 2009 May;20(2):363-72. in PubMed

Functional Neuroimaging of Fatigue. - The lack of a relationship between self-reported fatigue and objectively measured fatigue is outlined, and new functional imaging paradigms may lead to significant advances in relating cognitive fatigue to functional cerebral activity. - Phys Med Rehabil Clin N Am. 2009 May;20(2):325-337. in PubMed

Depression and immunity: inflammation and depressive symptoms in multiple sclerosis. - This article reviews the current knowledge in the field and illustrates how the sickness behavior model may be applied to investigate depressive symptoms in inflammatory neurologic diseases. - Immunol Allergy Clin North Am. 2009 May;29(2):309-20. in PubMed

Enhancing the Ability of Experimental Autoimmune Encephalomyelitis to Serve as a More Rigorous Model of Multiple Sclerosis through Refinement of the Experimental Design. - Comp Med. 2009 Apr;59(2):112-28. in PubMed

[Effectiveness of rehabilitation in multiple sclerosis] - Comprehensive rehabilitation significantly influenced on functional improve patient with multiple sclerosis and decrease disability score. - Pol Merkur Lekarski. 2009 Mar;26(153):205-7. in PubMed

Multiple sclerosis and the major histocompatibility complex. - The MHC class II association with MS is not as straightforward as previously thought. A complete understanding of the epistatic interactions and epigenetic features of this region will be important to understand disease pathogenesis and likely aid the discovery of new therapeutics. - Curr Opin Neurol. 2009 Apr 20. [Epub ahead of print] in PubMed



What Are Friends For? A Longer Life

In the quest for better health, many people turn to doctors, self-help books or herbl supplements. But they overlook a powerful weapon that could help them fight illness and depression, speed recovery, slow aging and prolong life: their friends.

Researchers are only now starting to pay attention to the importance of friendship and social networks in overall health. A 10-year Australian study found that older people with a large circle of friends were 22 percent less likely to die during the study period than those with fewer friends. A large 2007 study showed an increase of nearly 60 percent in the risk for obesity among people whose friends gained weight. And last year, Harvard researchers reported that strong social ties could promote brain health as we age.

“In general, the role of friendship in our lives isn’t terribly well appreciated,” said Rebecca G. Adams, a professor of sociology at the University of North Carolina, Greensboro. “There is just scads of stuff on families and marriage, but very little on friendship. It baffles me. Friendship has a bigger impact on our psychological well-being than family relationships.”

In a new book, “The Girls From Ames: A Story of Women and a 40-Year Friendship” (Gotham), Jeffrey Zaslow tells the story of 11 childhood friends who scattered from Iowa to eight different states. Despite the distance, their friendships endured through college and marriage, divorce and other crises, including the death of one of the women in her 20s.

Using scrapbooks, photo albums and the women’s own memories, Mr. Zaslow chronicles how their close friendships have shaped their lives and continue to sustain them. The role of friendship in their health and well-being is evident in almost every chapter.

Two of the friends have recently learned they have breast cancer. Kelly Zwagerman, now a high school teacher who lives in Northfield, Minn., said that when she got her diagnosis in September 2007, her doctor told her to surround herself with loved ones. Instead, she reached out to her childhood friends, even though they lived far away.

“The first people I told were the women from Ames,” she said in an interview. “I e-mailed them. I immediately had e-mails and phone calls and messages of support. It was instant that the love poured in from all of them.”

When she complained that her treatment led to painful sores in her throat, an Ames girl sent a smoothie maker and recipes. Another, who had lost a daughter to leukemia, sent Ms. Zwagerman a hand-knitted hat, knowing her head would be cold without hair; still another sent pajamas made of special fabric to help cope with night sweats.

Ms. Zwagerman said she was often more comfortable discussing her illness with her girlfriends than with her doctor. “We go so far back that these women will talk about anything,” she said.
Ms. Zwagerman says her friends from Ames have been an essential factor in her treatment and recovery, and research bears her out. In 2006, a study of nearly 3,000 nurses with breast cancer found that women without close friends were four times as likely to die from the disease as women with 10 or more friends. And notably, proximity and the amount of contact with a friend wasn’t associated with survival. Just having friends was protective.

Bella DePaulo, a visiting psychology professor at the University of California, Santa Barbara, whose work focuses on single people and friendships, notes that in many studies, friendship has an even greater effect on health than a spouse or family member. In the study of nurses with breast cancer, having a spouse wasn’t associated with survival.

While many friendship studies focus on the intense relationships of women, some research shows that men can benefit, too. In a six-year study of 736 middle-age Swedish men, attachment to a single person didn’t appear to affect the risk of heart attack and fatal coronary heart disease, but having friendships did. Only smoking was as important a risk factor as lack of social support.

Exactly why friendship has such a big effect isn’t entirely clear. While friends can run errands and pick up medicine for a sick person, the benefits go well beyond physical assistance; indeed, proximity does not seem to be a factor.

It may be that people with strong social ties also have better access to health services and care. Beyond that, however, friendship clearly has a profound psychological effect. People with strong friendships are less likely than others to get colds, perhaps because they have lower stress levels.

Last year, researchers studied 34 students at the University of Virginia, taking them to the base of a steep hill and fitting them with a weighted backpack. They were then asked to estimate the steepness of the hill. Some participants stood next to friends during the exercise, while others were alone.

The students who stood with friends gave lower estimates of the steepness of the hill. And the longer the friends had known each other, the less steep the hill appeared.

“People with stronger friendship networks feel like there is someone they can turn to,” said Karen A. Roberto, director of the center for gerontology at Virginia Tech. “Friendship is an undervalued resource. The consistent message of these studies is that friends make your life better.”


Biogen's Tysabri Reports 6th Case

6th Case of PML Found in Tysabri Patients

This past weekend, Biogen Idec, Inc. (BIIB) reported that another patient taking Tysabri had developed a case of progressive multifocal leukoencephalopathy, or PML.

This is the sixth case of PML since July 2008. In the most recent case, a patient being treated for multiple sclerosis on Tysabri developed the disease after 31 months. All patients are taking Tysabri as a notherapy, with the minimum therapy before noted disease of 12 months. The average length of time for the sixth patients dosing is 19 months. Five of the six reported cases were located outside the U.S.

Despite the new case of PML, Biogen Idec and Elan continue to educate and train physicians under the risk management plan (RiskMAP). This includes the recent warning on potential liver damage as well. As of the end of the first quarter, there are currently 39,900 patients on Tysabri worldwide (20,800 in the U.S, 18,500 Ex-U.S, 600 in clinical trials).

Some 25,000 patients have been on the drug over 1-year, with 14,400 patients on the drug over 18 months and 6,800 on the drug over two years. When re-approved in June 2006, Biogen, Elan, and the FDA / EMEA agreed the risk threshold for keeping the drug on the market would be 1/1000. Using the 18+ month 18,500 patient group, the current incidence rate of 6/18,500 still falls well within the acceptable range.

We continue to expect reported cases of PML over the next several quarters. Biogen has been reporting, on average, about one new case per quarter. However, given the powerful efficacy of the drug, as well as the increased education and awareness around PML, we do not believe this will be a significant deterrent to new patient growth.

Worldwide sales of Tysabri were $227 million, $116 million in the U.S. and $111 million outside the U.S., in the first quarter. Despite the most recent case of PML, we expect that Tysabri revenues will grow to $1,045 million ($536 million in the U.S. and $509 million internationally) worldwide in 2009. Full report in Zacks Investment Research

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'Amazing Race' host stops in Iowa City

A television personality biking across America to raise awareness about multiple sclerosis got a warm welcome in Iowa City during an otherwise chilly morning.

The wind was blowing and the temperatures were in the low 40s when Phil Keoghan, host of CBS’s The Amazing Race, rode into Hubbard Park on the University of Iowa campus around 8:40 a.m. Tuesday. Keoghan is riding from Los Angeles to New York City to raise awareness about multiple sclerosis for the National MS Society.

“It’s so significant and we’re so grateful to Phil and the Amazing Race team to be raising money and awareness,” said Joe Lock, a Board of Trustee member for the MS Society.

Despite the chilly temperatures, about 20 people showed up to meet-and-greet Keoghan. During his 30 minute appearance at the park, Keoghan had a little fun with Iowa City Councilor Ross Wilburn and Herky the Hawkeye.

Keoghan, a native of New Zealand, seemed a little confused as Herky rode up on a bike.

“You are going to have to explain that to me,” Keoghan said to Wilburn.

Wilburn, an avid cyclist, thanked Keoghan for appearing in Iowa City and for the work he was doing.

“I just want to thank you for passing through Iowa City,” Wilburn said. “You are raising awareness for multiple sclerosis, that’s a fantastic thing.”

Keoghan said the bicycle ride across the country, which he is also using to promote 'The Amazing Race' and his One Square Meal food bar, has been difficult at times. Keoghan said he was hospitalized a few days ago for dehydration. On Tuesday, though, Keoghan said his biggest trouble was a sore backside after riding halfway across the country.

Wilburn said he would accompany Keoghan for 15 to 20 miles on the next leg of his trip to Davenport. The city councilor also invited Keoghan to come back this summer for The Register’s Annual Great Bicycle Ride Across Iowa, but the TV host declined.

“Right now, when this is done, riding is the last thing I want to do,” Keoghan said.

Wilburn presented Keoghan with an Iowa City paperweight and Keoghan presented Wilburn with a sample from his food bar. Wilburn wished him well on the rest of his trip.

“May there be a tail wind at your back the whole way,” he said.
Story in the


.Paralysis More Prevalent, Study Finds

Some 5.6 million people in the U.S. have some form of paralysis and nearly a quarter of them have suffered spinal-cord injuries, a new report says.

The report being released Tuesday is the result of an ambitious effort by the Christopher and Dana Reeve Foundation to put a number on the population that suffers from movement-limiting disorders. Prior estimates on paralysis and spinal-cord injury were significantly smaller, but they relied on narrower data-collection techniques.

The new estimate was based on a telephone survey of more than 33,000 U.S. households in which participants were asked whether they or anybody else in the household had any difficulty moving their arms or legs. Those who said yes were included in the group with some form of paralysis if their difficulty moving was caused by a disease or injury affecting their central nervous system, such as a spinal-cord injury, stroke, multiple sclerosis or cerebral palsy. Patients whose difficulty was caused by arthritis, for instance, were left out.

The study found the average number of years since onset of paralysis was about 16, a number that is believed to be rising because paralysis patients are living longer. About two-thirds of those suffering from paralysis had annual household incomes of less than $30,000.

"There has not been a good way, previously, of determining the number of people who live in this country with a range of conditions like this," says Gloria Krahn, director of the Centers for Disease Control and Prevention's human development and disability division. "We are very interested in having good data to help us ensure that we are directing activities and health-promotion activities in the right ways."
Full story in The Wall Street Journal



Biogen reports 6th case of PML in Tysabri patients

BOSTON, April 20 (Reuters) - A sixth patient taking Biogen Idec Inc's (BIIB.O) multiple sclerosis drug Tysabri has developed a potentially deadly brain infection since the drug was reintroduced onto the market in July 2006.

The Cambridge, Massachusetts-based biotech company announced the news late on Friday on its website, saying the case was confirmed on April 15th.

Biogen has said it does not plan to announce each new case of progressive multifocal leukoencephalopathy, or PML, except as a weekly update on its website.
Even so, the confirmation occurred a day before Biogen's first-quarter earnings conference call, and some analysts questioned why the company did not mention it.

"While we applaud management's decision to update PML cases weekly, we think it's fair to ponder why this wasn't fully discussed on the earnings call," said Christopher Raymond, an analyst at Robert W. Baird, in a research note.

A spokeswoman for Biogen was not immediately available for comment.

full story in Reuters

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Low Dose Naltrexone as a Treatment for Multiple Sclerosis

Low dose naltrexone, or LDN, seems to almost have "cult-like" status among people with multiple sclerosis. Most people have never even heard of it (including some general practitioners that I have spoken with). Many neurologists shake their heads in disgust when their patients bring it up, refusing to even consider prescribing it. However, among many of the people with MS that have tried it and are compelled to share their stories, this is THE drug to use.

In case you have not yet gotten caught up in the talk surrounding LDN, here is the lowdown: Naltrexone is an opiate agonist, and at the usual dosage of 50 to 100 mg, is used to help people stop abusing alcohol or narcotics (opioid drugs). Low dose naltrexone refers to the “off-label” use of naltrexone at a fraction of the usual dose, which is thought to help MS through a possible variety of mechanisms, including increasing sensitivity to endorphins, reducing inflammation and/or reducing production of free radicals. This has the following (reported) results among people with MS:

stops progression of multiple sclerosis disability,
prevents relapses, and
reduces MS symptoms.

The very unfortunate thing about LDN is that there has been very little research conducted on its use in people with MS. All of those stories just add up to be a bunch of stories, and not actual data, without being captured in the structure and rigor of a clinical trial.

for full blog & links


The next best thing - Senior with MS finds a fun way to obey doctor’s orders

Don’t ever count Bud Schiffman out.

When a doctor told the 95-year-old cyclist that he wasn’t in shape to make the weekend’s BP MS 150 bike ride, he was deeply disappointed. He’d participated in the fundraising trek to Austin for the past three years, and even though he rode a three-wheeled bike and came in last every year, he raised more than $20,000 for multiple sclerosis research.

Also, he made lots of friends.

“We love you, Bud,” riders would call out as they passed him. “You’re my inspiration!”

No worries. This past weekend, Schiffman figured out a way to ride again.

Last Thursday he joined Team Betaseron,a group of people with multiple sclerosis who participate in the annual ride, but on stationary bikes. They maintain the same race schedule and pedal roughly the same distance as the other 13,000 riders, but they do it in the air-conditioned comfort of Texas Orthopedic Hospital on Main.

Being indoors was a huge advantage this year. While ride organizers canceled the first leg of the

trip because of thunderstorms and flooding, Schiffman and Team Betaseron met as planned Saturday morning and rode about 80 miles. Sunday, they did it again. Who’s counting, but Schiffman and the MS patients rode twice as far as their more conventional teammates this weekend.

At the hospital, Schiffman finished about 3 p.m. Sunday — in last place again. He could have gone faster, he said, but he was talking all the way.

Also, he stopped for lunch, which he doesn’t usually do. “It was outstanding,” he said, licking his lips at the memory. “Barbecue.” Schiffman is a transplanted Houstonian. His first 90 years were spent in New York, where he and his wife, Zelda, raised two children and he worked as a furniture manufacturer.

After his wife’s death, he moved here to live with his daughter, neuro-ophthalmologist Jade Schiffman. He learned how to use a computer, and he started working out five days a week at the Weekley Family YMCA, where he is a minor celebrity.

His pals at the YMCA need to hold on to their wallets: Schiffman may have put in his miles, but he has only just begun to raise funds............... story in the Houston & Texas news



What's new for 'Multiple Sclerosis' in PubMed

The clinical and urodynamic results of a 3-month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis-related neurogenic bladder dysfunction. - Neurourol Urodyn. 2009 Apr 16. [Epub ahead of print] in PubMed

How the Conflict between American Psychiatry and Neurology Delayed the Appreciation of Cognitive Dysfunction in Multiple Sclerosis. - Whereas cognitive deficits in multiple sclerosis (MS) were documented in the original clinicopathological description by Charcot, the extent and nature of cognitive dysfunction was poorly understood in the U.S. until over a century later. Our objective was to discern reasons for this misunderstanding and to examine forces shifting this topic to center stage of research and increased awareness in clinical practice. - Neuropsychol Rev. 2009 Apr 17. [Epub ahead of print] in PubMed

Lower urinary tract symptoms in women with multiple sclerosis: part 1. - This article, the first in a two-part series, examines how MS can affect normal bladder function, looking at what symptoms patients may present with. It also provides an overview of how nurses can assess and diagnose these bladder problems. The conservative, pharmacological and surgical interventions for the management of lower urinary tract symptoms will be discussed in the second part of this series. - Br J Nurs. 2009 Apr 9-22;18(7):S14-8. in PubMed

A UK consensus on the management of the bladder in multiple sclerosis. - The evidence for other measures, including physiotherapy, alternative strategies aimed at improving bladder emptying, other medications and detrusor injections of botulinum toxin A was reviewed. The management of urinary tract infections as well as the bladder problems as part of severe disability were discussed and recommendations agreed. - J Neurol Neurosurg Psychiatry. 2009 May;80(5):470-7. in PubMed

IL-17 and Th17 cells in human inflammatory diseases. - Microbes Infect. 2009 Apr 13. [Epub ahead of print] in PubMed



Updated: 'Amazing Race' host pit stop

Friday, April 17, 2009 - Bikers, from left, Todd Felber, Dennis Shannon, Dallas Hayes and Don Pierce and cyclists Tor Olson, Randy Andrews, Candy Crosby and Harold Beebe were among those escorting Phil Keoghan, front, the celebrity host of the CBS television show "The Amazing Race" from a rally in McCook's Kelley Park to U.S. Highway 6-34 Tuesday morning.

Keoghan's blog about his stop in McCook is posted HERE

Keoghan is bicycling from Los Angeles to New York, raising awareness of multiple sclerosis -- "a tremendously cruel disease," he called it -- and funds for research and the search for a cure. The goal of Keoghan's cross-country bike ride, he told supporters gathered for breakfast in the park, is to raise $250,000 for the National Multiple Sclerosis Society. Keoghan said he "fell in love with" the society's "heartfelt effort" and its focus, energy and passion. "It's quite extraordinary," he said. "Nothing compares." Keoghan's park rally was coordinated by the McCook Area Chamber of Commerce. Keoghan and his entourage planned overnight stops in only 30 communities; his next will be in Holdrege....... story in McCook Daily Gazette


Biogen Idec Showcases Leading Multiple Sclerosis Franchise and Pipeline at the 61st Annual Meeting of the American Academy of Neurology

CAMBRIDGE, Mass.--(BUSINESS WIRE)--Biogen Idec (NASDAQ: BIIB) today announced that 25 company-sponsored platform and poster presentations will take place during the 61st Annual Meeting of the American Academy of Neurology (AAN) in Seattle, WA, April 25 through May 2, 2009. These presentations, which are not late-breaking abstracts, will cover five compounds that are marketed or currently in development by Biogen Idec and its partners for the treatment of multiple sclerosis (MS). This includes two approved therapies for MS; TYSABRI® (natalizumab) and AVONEX® (Interferon beta-1a); and additional compounds in development including Tecfidera (BG-12/dimethyl fumarate), PEGylated interferon beta-1a, and daclizumab.

“Biogen Idec is redefining success for patients living with MS. With TYSABRI, we have moved beyond slowing disease progression. We are even seeing some clinical trial patients who are free from MS disease activity or with physical improvement from what was seen at baseline,” said Michael Panzara, MD, MPH, vice president, chief medical officer of neurology, Biogen Idec.
Dr. Panzara continued, “Biogen Idec is at the forefront of development and research with a robust pipeline that includes PEGylated interferon beta-1a, which is expected to enter a Phase III clinical trial by the middle of this year. Biogen Idec has been a pioneer for over a decade in the use of interferon beta to treat MS, and this compound promises to be a significant evolution in that class.

Also, BG-12, an oral compound with potential neuroprotective effects, has shown promising results in early-stage MS and is now well into Phase III trials with over 2000 MS patients currently enrolled. Indeed, with multiple exciting compounds to treat MS at all stages of development, including those at the preclinical stage with the potential to reverse and repair the damage inflicted by the disease, Biogen Idec continues to demonstrate our commitment to improving the lives of MS patients worldwide.” .............. full report in BusinessWire

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Multiple sclerosis and vitamin D: don't (yet) blame it on the sunshine

It is all but 50 years since Sir Donald Acheson proposed a relationship between solar radiation and multiple sclerosis (Acheson et al., 1960). The subsequent discovery of the link between sunlight and vitamin D raised the potential for dietary supplementation to prevent or ameliorate the most common chronic neurologic disease of young adults.

Research in the field has proceeded down two distinct lines: epidemiological studies aimed at confirming and refining the association; and studies directed towards providing biological plausibility that may advance association to causation or at least justify large-scale clinical trials with an inexpensive agent. If definitive evidence is represented by a completed jigsaw puzzle......full text article in Brain: A Journal of Neurology in Oxford Journals


What's new for 'Multiple Sclerosis' in JNNP Online

Decreased T cell reactivity to Epstein–Barr virus infected lymphoblastoid cell lines in multiple sclerosis - Journal of Neurology, Neurosurgery, and Psychiatry 2009;80:498-505 - JNNP Online

A UK consensus on the management of the bladder in multiple sclerosis - Throughout the course of their disease, patients should be offered appropriate management options for treatment of incontinence, the mainstay of which is antimuscarinic medications, in combination, if necessary, with clean intermittent self-catheterisation. The evidence for other measures, including physiotherapy, alternative strategies aimed at improving bladder emptying, other medications and detrusor injections of botulinum toxin A was reviewed. The management of urinary tract infections as well as the bladder problems as part of severe disability were discussed and recommendations agreed. - Journal of Neurology, Neurosurgery, and Psychiatry 2009;80:470-477 in JNNP Online

Epstein–Barr virus (EBV) and multiple sclerosis association: EBV has a primary or secondary role? - Multiple sclerosis (MS) is a complex pathology of the CNS in which genetic and environmental factors, such as viral infections, act together to cause disease. Epstein–Barr virus (EBV) represents one of the leading candidates among the infectious agents for which there is the most relevant evidence for an association with MS - Journal of Neurology, Neurosurgery, and Psychiatry 2009;80:469 .......full text article in JNNP Online



Stem Cells Offer Potential Multiple Sclerosis Treatment

MONDAY, April 13 (HealthDay News) -- Oligodendrocytes generated from human embryonic stem cells that produce myelin offer novel possibilities for basic and clinical research into treatments for multiple sclerosis, but the process is more protracted than in mouse cells, according to a study published online April 10 in Development.

Bao-Yang Hu, of the University of Wisconsin in Madison, and colleagues used human embryonic stem cells to see if a process already achieved in mouse embryonic stem cells, which turns them into oligodendrocytes, could be replicated in human cells. ......full article in Modern Medicine

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