Questions on the road

Progressive MS, back in the limelight.

At all medical/research meetings, neurologist clamor for the development of treatment for progressive MS -- this ECTRIMS (European Committee for Treatment and Research in MS) is no different.

On the way to Dusseldorf, Germany, I received the following question:

Question:

What treatment options are there for those of us who of progressive ms.....all the medications that are out there are for those people who have had events and I have never had one.....

Answer:

Unfortunately all of the currently FDA approved disease modifying medications work mostly in relapsing remitting MS (RRMS).

We often use chemotherapies in the treatment of progressive MS -- such as, mitoxantrone (novantrone), cyclophosphamide (cytoxan), etc.

More recently there have been trials with dirucotide (MBP8298), with unfortunately negative results.

There are ongoing trials with FTY720 (fingolimod) and many of us believe that rituximab (rituxan) works in progressive MS (despite the clinical trial) -- we will see what happens with ocrelizumab.

At Neurologique, we are working diligently on developing a medication for progressive MS; once clinical trials commence, we will be sure to announce this prominently.

The follow-up question was:

Question:

Are there any natural ways to help with progressive ms....I am taking 4000 IU of Vit D as my level is low and I take B12 shots every other week to maintain my levels close to 600.....are they are other suggestions to keeping this at bay.....many thanks.....Barb Sengstaken....I don't mind my email or name listed on your below listed question because perhaps people like me would like to chat on email unless you think that is not safe......

Answer:

t depends what you mean by "natural."

B12 levels of 600 are not that high, so you may want to consider with your doctor going higher and there may be a reason why despite the injections, your levels are still not very high.

Some patients opt to take LDN (low dose naltrexone), but this is hadly "natural."

See:

http://www.youtube.com/watch?v=Kz52KK5IhOc

Another great question was raised by a highly trained patient:

Question:

Recently, Dr. Galipeaux from McGill University published a paper that astounded many of us. From their results, it would appear that there might be a cure for MS sometime in the future. Has the action of a fusion protein for humans like the one they made for mice been constructed yet, and if so, what is the plan for clinical trials to test its efficacy?

I realize that the possibility of immune reaction against such a protein is possible, but if the outcome is anything like what happened in the mice, MS could actually be cured in our lifetime.

Thanks for your help with this issue.

Answer:

The mouse research suggests that by mixing B-cells (a type of immune cells) with a combination of two proteins (GIFT15) can then be infused back into the mouse to cause immunosuppression.

While this sounds exciting, we have to be careful in trying to manipulate the immune system (an example was the attempt to use interferon gamma to treat MS, when we now know that it worsens MS). The other issue is that we cannot always generalize our findings in mouse models to human beings with MS.

Also, this treatment is a strong immunosuppressant, but it does not directly reverse MS (it just halts the body from further attacking itself) -- much like alemtuzumab (campath) and high dose cyclophosphamide (HiCy).

Getting back to daily reality, I received the following question:

Question:

Why are my MS symptoms so much worse during the time if the month??

Answer:

During your period, your core body temperature rises, which leads to an uncovering of older MS symptoms.

This is called Uhthoff's phenomenon -- see:

http://www.medhelp.org/posts/Multiple-Sclerosis-MS/MS-Symptoms-and-being-sick/show/756505

- Dr. Daniel Kantor, MD BSE
Medical Director
Neurologique

info@neurologique.org
www.neurologique.org