Breaking News from Seattle

The American Academy of Neurology annual meeting is in Seattle the week of April 27-May 1, 2009.  

Oral Cladribine reduced relapses by 58% vs. placebo based on the lower of two doses.  The CLARITY trial studied 1326 MS patients over two years.  More patients were relapse free (80%) on treatment with the lower dose than on placebo (61%).  The patients on the low dose of cladribine were 33% less likely to progress in disability.  T1 contrast lesions dropped 86-88% on treatment.  Side effects included low white counts (22-32%), shingles (2%), and some hair loss (3.5%).  One treated patient died with tuberculosis.

FTY720 oral daily treatment compared to Avonex injections reduced relapses 52%  on  the lower dose of FTY720.  The TRANSFORMS  trial studied 1292 patients for 1 year.  More patients were relapse free (83%) on FTY720 than on Avonex (69%).  Side effects and risks included transient slowing of  heart rate and 8 cases of back of the eye swelling (macular edema).  Three cases of melanoma skin cancer were discovered on first dermatology evaluation as part of the trial monitoring.  One death from severe chicken pox in someone also receiving steroids who was never vaccinated or exposed as a child.  One death from herpes encephalitis with a delay of 1 week of diagnosis and treatment.  The MS Center for Innovations in Care was a trial site for this international study.

Rituximab antibody treatment was not helpful in primary progressive MS  overall based on a study of 439 patients.  Rituximab seemed to be effective in the 25% of patients with T1 Contrast lesions on their baseline scan, which is a marker of ongoing active brain inflammation.   

Ginseng, unfortunately, wasn’t very effective for fatigue in a small trial. 

Namenda, an Alzhemier’s medication, did not help thinking in people with MS.

Smoking before age 17 can increase the risk of developing MS 2.7 times.

ATL-TV1102 is a treatment that binds to DNA strands.  The treatment affects a molecule important for white blood cells to cross into the brain. The cumulative number of T1 contrast brain lesions dropped 67% over 12 weeks on treatment.