Remyelination: Repairing Multiple Sclerosis
Myelin is the coating on the nerve cells (neurons) of the nervous system that allows messages to travel rapidly in our body. Myelin wrapped around the neurons also keeps neurons healthy. In multiple sclerosis, the immune system attacks myelin disrupting electrical signals and making neurons vulnerable to chronic damage. Remyelination is the strategy to recoat the nerves with new myelin. Myelin-making cells called oligodendrocytes (“oligos”) are described. The podcast reviews recent laboratory breakthroughs in screening for new treatments to turn on immature oligos to repair myelin. The exciting initial steps are presented regarding the transition from the laboratory research into clinical trials with multiple sclerosis patients.
Barry Singer, MD, Director of The MS Center for Innovations in Care at Missouri Baptist Medical Center interviews:
Ari J. Green, MD, Chief of Division of Neuroinflammation and Glial Biology, Medical Director of the Multiple Sclerosis and Neuroinflammation Center, Debbie and Andy Rachleff Distinguished Professor of Neurology, Departments of Neurology and Ophthalmology, University of California San Francisco.
Sep 3 2019 MSLivingWell Podcast 1. Winning Strategies in Multiple Sclerosis Treatment: Don’t Underestimate the Disease.
Treatment approaches to multiple sclerosis continue to change. Over the past quarter of a century, MS went from an untreatable disease to a disease responsive to a broad array of oral, intravenous and self-injected medications. Greater long-term disease control is now possible for more people living with MS. However, undertreatment can result in significant physical disability including imbalance, weakness, visual loss, incontinence and pain and significant cognitive impairment including short-term memory loss, multitasking impairment and word-finding problems. This podcast outlines different treatment strategies to maximize quality of life long-term to realize your individual goals with the least disability. Information is presented on which people with MS might be at increased risk of disability and need early use of a highly effective medication. Treatment safety is weighed against the treatment benefits and risk of long-term disability.
Barry Singer MD, Director of The MS Center for Innovations in Care, interviews two amazing MS specialists who are also phenomenal patient advocates:
Heidi Crayton MD, Director of The MS Center of Greater Washington in the Virginia suburbs of Washington, DC. Dr. Crayton completed her neurology residency and multiple sclerosis fellowship at Georgetown University Hospital. She is a national leader in MS treatment and clinical trial investigator. For more on Dr. Crayton.
Aaron Boster, MD, is an MS expert at Ohio Health in Columbus, Ohio. Dr. Boster completed his neurology residency at the University of Michigan in Ann Arbor and a fellowship focused on clinical neuroimmunology and multiple sclerosis at Wayne State University in Detroit. Dr. Boster continues to be active in clinical research, authoring academic publications and lecturing globally. For more on Dr. Boster.
Join us for a free educational evening at Missouri Baptist Medical Center for The MS Center for Innovations in Care annual “MS Breakthroughs” program on Oct 22, 2019. The latest groundbreaking global research including treatment updates will be presented. Future developments to better monitor MS disease activity in patients will be shared. Myelin-repair strategies will also be highlighted.
Representatives of the Multiple Sclerosis Association of America, National MS Society, Missouri Baptist Therapy Services and other MS care partners will be present.
Formal presentation will be from 6-7:30 PM followed by a 30 minute question and answer session. RSVP information coming…
Mavenclad is an oral medication approved for relapsing-remitting and secondary progressive multiple sclerosis. The oral treatment course consists of two yearly courses of 2 cycles of 1-2 tablets per day for 4-5 days depending on the patient’s weight.
In the CLARITY study, 1326 multiple sclerosis patients were randomized to a total dose of 3.5 mg/kg (FDA-approved dose), 5.25 mg/kg or placebo. Mavenclad 3.5 mg/kg total dose reduced relapses by 58% compared to placebo. Likelihood of progression of disability was reduced by 33% on Mavenclad. On MRI, Mavenclad reduced contrast-enhancing lesions by 86% and new or enlarging T2 lesions by 73% compared to placebo.
Risks of Mavenclad include low white blood cell counts, serious infections, anemia, potential fetal harm and possible malignancy. Per prescribing information, use of MAVENCLAD is generally recommended for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug indicated for the treatment of MS due to its safety profile.
Mayzent (siponimod) is a tablet medication to treat people with both relapsing-remitting multiple sclerosis and secondary-progressive patients with active disease such with new relapses or new MRI activity.
In the EXPAND trial, 1651 multiple sclerosis patients with secondary-progressive multiple sclerosis were randomized to once-daily oral Mayzent 2 mg daily or placebo for up to 3 years (2/3 of patients received Mayzent). Patients on Mayzent had a 21% less risk of disability progression than those patients on placebo. Mayzent reduced relapses by 55% compared to placebo. Patients on Mayzent were more likely to be free of contrast-enhancing lesions (89% vs 67% on placebo) and free of new or enlarging T2 lesions (57% vs. 37% on placebo).
Medication risks include elevation of liver blood test, swelling back of eye (called macular edema), increase in blood pressure and potential serious infections.
Available now! Dr. Susanne Bennett on RadioMD interviews Dr. Barry Singer on the symptoms and signs of multiple sclerosis. He discusses genetic and environment risk factors for MS. Wellness including exercise addressed. Impact of treatments on preventing disability reviewed.
JOIN US!! December 4, 2018 from 6:30 PM to 8:30 PM. Find out the latest in multiple sclerosis advancements after the largest global MS meeting called ECTRIMS which is Oct 10-12, 2018 in Berlin this year. Barry Singer, MD, Mark Tullman, MD, Barbara Green MD and Melanie Huff NP-C from The MS Center for Innovations in Care will present the most promising and impactful results. New information on multiple sclerosis treatment and myelin repair will be reviewed. Free program. RSVP at 314-996-LIFE or 1-800-392-0936.
The program will be on the CAMPUS of MISSOURI BAPTIST MEDICAL CENTER in the Clinical Learning Institute which is conveniently above the main garage next to the main entrance of the hospital (and in the same building at the Goldfarb School of Nursing).
Jul 14 2018 We’ve Moved! New Center Opens!
The MS Center for Innovations in Care has moved from the 2nd floor of Building B to our brand new space on the FIRST FLOOR of Building B, Suite 105 on the campus of Missouri Baptist Medical Center. The Center is now conveniently located across the hall from the outpatient lab and next door to the new MS Infusion Center, the region’s only MS-specific infusion center. With double the square feet, the new center features 10 large exam rooms with accessible exam tables, open nursing stations and clinical research space. The Center’s staff includes 3 highly-experienced MS specialists, a MS-certified nurse practitioner, 2 MS nurses, a research coordinator and 8 other support staff including medical assistants. Our phone number and fax number have not changed.
May 18 2018 Upcoming Program: Understanding MS Progression
The Multiple Sclerosis Association of America (MSAA) invites you to a free educational program on:
Understanding MS Progression: The Importance of Treatment Adherence
Presenter: Barry Singer, MD, Director of The MS Center for Innovations in Care at Missouri Baptist Medical Center
Tuesday June 19 2018 Registration 6:00-6:30 PM, Program 6:30 PM to 8:00 PM
Hilton St. Louis Frontenac, 1335 S. Lindbergh Blvd., St. Louis, MO 63131
Register by Wednesday June 13: 1-800-532-7667, ext. 188 or online at support.mymsaa.org/stlouis
We are extremely pleased to announce that Dr. Barbara Green will be joining our center February 15, 2018. Dr. Green is a true leader in multiple sclerosis with extensive experience in treating patients with multiple sclerosis including as a long-standing director of a multiple sclerosis center in St. Louis. She is passionate about superb MS patient care. As a committed advocate of those living with multiple sclerosis, Dr. Green has served as chair of the clinical advisory committee for the Gateway Chapter of the National Multiple Sclerosis Society.