Global MS Meeting ECTRIMS 2013 Highlights

Comi presented follow-up on 699 MS patients followed on MS treatment for 8 years.  New MRI activity and relapses predict disability risk.

Over 5 year BENEFIT study,  low vitamin D increased risk of new MRI activity and brain atrophy (shrinkage).  In addition, low vitamin D increased the risk of disability progression. Best to get vitamin level greater than 50.

Aubagio  (teriflunomide) 14 mg decreased the likelihood of a 2nd MS attack by 43% and reduced new enhancing MRI activity by 59%.   The 7 mg dose was less effective with 37% less likelihood of a 2nd attack and 21% less contrast MRI activity.

Why is MS rare in HIV+ people?  Gold presented results from United Kingdom database of 55 million people between 1999 to 2001.  Out of the greater than 21,000 HIV+ patients, only 7 also had MS.  Greater than 18 people with both diseases would have been expected.  Could be that anti-viral therapy for HIV helps MS?   Trial beginning with MRI scans for raltegravir.

Farez presented an Argentinian study on salt intake in 122 people with MS.  Greater than 2 grams/day of salt (calculated from random urine sodium measurements) was associated with more MRI activity and more relapses.  Sodium blood levels appeared unrelated.

Smoking increases the risk of developing MS.  Men who smoke a pack per day for 16 years have three times the risk.  Quit smoking for 10 years and risk declines.

TOFINGO Trial results examined the timing of switching patients from Tysabri to Gilenya.  78-82% of patients were JC virus positive.   If patients waited 8 weeks to start Gilenya after the last Tysabri infusion, 75% of people were free of contrast T1 brain acitivity.  For 12 week and 16 week washouts, 61.3% and 47.5% of people were free of contrast MRI lesions respectively.