LINKOptic neuritis is one of the earliest and most common presenting symptoms for patients with multiple sclerosis. Therefore, optometrists play an important role in diagnosing multiple sclerosis. These patients should be comanaged with a neurologist and/ or neuro-ophthalmologist, and each must have a working understanding of this disease.

OPTIC NEURITIS SPECIFICALLY FEATURES PAIN UPON EYE MOVEMENT AND AN ACCOMPANYING GRADUAL LOSS OF VISION.

LINK-Harvard School of Public Health
Researchers from the Harvard School of Public Health reported that current and past smokers with multiple sclerosis were more than three times as likely as patients who had never smoked to have more rapid progression of their disease.

LINK Forbes.comNovartis AG said new tests with FTY720, an oral medication for the treatment of multiple sclerosis (MS), showed a reduced rate of clinical relapses by more than 50 pct.

Moreover, inflammatory disease activity, as measured by magnetic resonance imaging (MRI), fell by over 80 pct over a six months period.

MSF Home: LINKThe FDA has added a warning to the labeling of Novantrone that includes additional information about the potential risk of heart damage (cardiotoxicity) and a form of leukemia (secondary acute myelogenous leukemia - AML).

The new FDA labeling requires repeat testing of cardiac function prior to each dose, in addition to the baseline testing of cardiac function which was recommended by the original labeling of Novantrone.

Source:Mayo Clinic - LINK“In practical terms, this is what our findings suggest: How much of the protein known as ‘interferon gamma’ you produce appears to be a new key variable in understanding who gets MS and who doesn’t, and especially why women develop MS more often than men,” explains the study’s lead author, Mayo Clinic neurologist Brian Weinshenker, M.D. “If you have a gene that produces high levels of interferon gamma, it may predispose you to developing MS. Under this scenario, men get MS less often because they have a lower frequency of a gene variant that is related to higher secretion of interferon gamma.”

MSAA News: LINK

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new University of Florida study - LINKThe patients in the study went through eight weeks of supervised resistance training on standard gym equipment, after which eight patients displayed stronger muscles, better walking, and less fatigue and disability.

The National Multiple Sclerosis Society funded the study.

CLICK HERE FOR LINK: Then click on nominees and then click on comeback...Cast your ESPY vote for Jordan SigaletJordan is a hockey player (goalie) and recently signed with the Boston Bruins. He was also diagnosed with MS and continues to break records. Announced today was the fact he is nominated for the ESPY (sports award equivilant of the Occars) for the Comback athlete.

linkThe risk of MS after optic neuritis may be predicted. The use of corticosteroids and IMAs, particularly in those at substantial risk, reduces the frequency and severity of developing CDMS. Earlier, more aggressive therapy in optic neuritis may be proven to reduce permanent axonal injury and progressive disability in MS.

CLICK HERE FOR: WebMD Transcript

LINK: " A monthly course of IV cyclophosphamide (Cytoxan) appears to have advantages over IV mitoxantrone (Novatrone, Onkatrone) given every 3 months for treatment of multiple sclerosis (MS), according to findings presented at the 15th meeting of the European Neurological Society (ENS)."

link Bayer markets the drug in Canada...Sativex is administered through a spray pump under the tongue or on the inside of the cheek.

MSF Home: LINK

Macleans.ca | link Sativex mouth spray isolates key medicinal ingredients from the marijuana plant

A drug containing two of the active ingredients in marijuana may help people with multiple sclerosis (MS) who are suffering chronic pain due to malfunctioning nerves.

Public Affairs Newsline

HealthDay LINK FOR FULL ARTICLEDetailed reports shed new light on why three patients who were treated with the biologic drug Tysabri for either multiple sclerosis or Crohn's disease developed severe brain infections.

In three scientific briefs and two editorials released Thursday by the New England Journal of Medicine, the specifics of each case are laid out and analyzed by experts in the field. The journal released the package early after a possible fourth case was reported last week. Two of the first three patients have died.

"This is the first time we've had a peer-reviewed report of the information provided by the company to the public," said Dr. John R. Richert, vice president for research and clinical programs for the Multiple Sclerosis Society. "It is the first time we have been able to peruse details of the cases."

Although the news of the infections first came as a blow to those in the MS community, Richert noted that some of the details in these case reports leave open the possibility that Tysabri might one day return to the market if screening methods are found to detect which patients might be susceptible to the brain infection.

Genetic Engineering News - LINK TO FULL ARTICLE
The Myelin Repair Foundation today announced that its collaboration of five of the world's leading neuroscientists has identified three new "switches," or signals, operating in the brain and spinal column that appear to turn on and off the nerve cell's ability to repair myelin. Myelin is the protective coating surrounding nerve cells that is damaged by MS. The scientists' findings are a critical first step in understanding myelin repair and its role in treatments for MS and other demyelinating diseases.

"We believe there are a number of mechanisms at work in MS which prevent immature brain cells from developing into myelinating cells, or cause the death of myelinating cells," says Rusty Bromley, COO of the Saratoga, California-based Myelin Repair Foundation. "We are excited that just one year into our research program our scientists have identified three key signals: one which causes the death of myelinating cells, one which amplifies the production of that signal, and one which stimulates developing cells to remyelinate. These findings point to specific opportunities to develop drugs to repair the damage being caused by Multiple Sclerosis."

Reuters Health LINKA possible fifth case of a rare and often fatal brain infection linked to the multiple sclerosis drug Tysabri has been reported to federal regulators, the Wall Street Journal reported on Monday.

The case was reported on May 16 through the Food and Drug Administration's Adverse Event Reporting System, which collects reports of possible drug reactions from physicians and drug makers. An FDA spokeswoman told the Journal that these reports do not represent confirmed cases.

MedlinePlus: LINK(Reuters Health) - Tysabri (natalizumab), an antibody treatment used for multiple sclerosis and Crohn's disease, has been linked to another case of progressive multifocal leukoencephalopathy (PML), a serious neurologic disease, bringing the total number of cases to four.

In light of this newest case, The New England Journal of Medicine (NEJM) today released early reports describing the first three cases.

In response to the additional report, Amy Brockelman, spokesperson for Biogen Idec, the maker of Tysabri, told Reuters Health that "we are reviewing any and all suspected cases of PML as part of our extensive safety evaluation and hope to have findings from that evaluation available by the end of summer."

All sales and marketing of Tysabri were suspended on February 28, and clinical trials of the drug have been halted, she added.

The fourth case was reported by the Boston Globe, which obtained its information from the FDA's adverse event reporting database, Brockelman said. But so far, only two of the cases have been fatal, she added. The fourth case is not yet confirmed.

According to the reports in the NEJM, two of the confirmed cases involved patients with multiple sclerosis, while the third occurred in a patient with Crohn's disease.

In a related editorial, Dr. Joseph R. Bergerat the University of Kentucky, Lexington, and Dr. Igor J. Koralnik, from Harvard Medical School in Boston, explain that PML is a rapidly progressive, often fatal brain disorder caused by infection of the nervous system with JC virus, a microbe that nearly everyone becomes infected with in childhood, but that usually remains dormant, causing no problems.

"The occurrence of PML in this setting was totally unexpected," they write, "since it almost invariably occurs in" patients with severe immune suppression, such as those with AIDS or organ-transplant recipients.

JC virus was detected in blood and brain fluid samples from the three confirmed case patients.

Bergerat and Koralnik suggest that ongoing measurement of JC virus levels, with subsequent dose adjustment or drug discontinuation, could prevent the development of PML in patients treated with drugs like Tsyabri.

In their case report, Dr. Annette Langer-Gould, from Stanford University School of Medicine in California, and her colleagues note that there was MRI evidence of PML one month before symptoms developed in the patient with Crohn's disease.

"More frequent MRI monitoring of patients who receive (Tysabri) may be warranted," they write.

LINKAccording to Dr. Jeffrey Drazen, the editor-in-chief of NEJM, while he sees a link between Tysabri and the onset of PML, further study is needed to determine whether the drug's benefits justify its risks. Tysabri is also known as natalizumab.

He says natalizumab does present a dilemma, as though it appears to be a promising therapy for multiple sclerosis and has raised the hopes of patients, the complication of PML can be fatal.

Drazen made his comments in an editorial about the formidable risks that clinical trial patients face. The editorial accompanied the analyses of data collected from three clinical trial patients who used Tysabri and subsequently contracted PM, two died from the disease. He says that though the association between natalizumab and the occurrence of PML seems clear, the level of that risk of PML per year of exposure is unknown.

PML is believed to be caused when a virus called the JC virus is reactivated and attacks the brain. and medical experts estimate that up to about 80% of the public carry the JC virus, which almost always remains dormant. PML, which is extremely rare, is most often seen in patients who are severely immuno-suppressed, such as those suffering from advanced AIDS, and is often fatal.

Other experts speculate that PML victims might stand a better chance of recovering if Tysabri was discontinued in the very early stages of the disease.

Biogen researchers hope that Tysabri could return to the marketplace if patients are strictly monitored for the onset of PML.

They say it is possible that testing for the appearance of JC virus in blood and discontinuing the natalizumab therapy would allow patients to recover.

The Biogen team say they are committed to a thorough evaluation of the safety profile of natalizumab.

Drazen has praised Biogen specifically for its handling of the clinical trial patients.

Biogen and Elan suspended all sales and testing of Tysabri in late February after two patients using the drug in a clinical trial were reported to have contracted PML. A third PML victim, also from a clinical trial, was identified in March. A fourth suspected case of the disease was reported to the FDA recently.

According to Biogen and the FDA, of the three confirmed PML cases, two of the patients have died, while a third survived, the fourth suspected victim is also alive.

Three of the patients, who suffered from multiple sclerosis, used Tysabri along with another Biogen drug, Avonex. A fourth patient, who suffered from Crohn's, had been taking Tysabri, along with a variety of other medications for his condition.

Since the discovery of the first two cases in February, Biogen and Elan have carried out a comprehensive medical review of the 5,000 patients who took Tysabri, to identify the trigger for PML. They hope to have the review completed by late summer, and will then discuss with the FDA whether Tysabri should be put back on the market and in what capacity.

LINKA Biogen Idec official has sent an e-mail message to neurologists suggesting that a suspected fourth case of a brain infection in a patient taking the drug Tysabri was a false alarm, according to two doctors who received the message. The e-mail message said the patient was shopping when she heard news reports last week that she had the potentially fatal infection.

Word of the e-mail message emerged on the same day The New England Journal of Medicine released several papers on the three people who contracted the rare but deadly viral infection after taking Tysabri, a multiple sclerosis drug.

The papers suggested, at least to Biogen, that it might be possible to detect the virus in blood early enough to avert serious consequences of the infection. If that were the case, it might be possible for the drug to return to the market. Biogen's interpretation was presented in a letter that will be published with the documents released today in the July 28 issue of the journal.

The possibility of a fourth case, first reported by The Boston Globe last week, was based on a report made by a health professional to the Food and Drug Administration.

This week, though, Dr. Michael A. Panzara, a medical official at Biogen, sent an e-mail message to some neurologists casting doubts on the report. Dr. Norman Kachuck of the University of Southern California, one of those who received the e-mail message, said it quoted from a message sent by the doctor treating that fourth suspected patient.

"I just spoke to my patient's daughter, 11:50 a.m., and she is alive and out shopping," the treating doctor wrote, according to Dr. Kachuck

Dr. Douglas R. Jeffery, who runs the multiple sclerosis clinic at Wake Forest University, said he had also received the e-mail message, but still had concerns. "It's fishy," he said, "because if that's the case, why didn't they say that to The Boston Globe right upfront?"

A spokeswoman for Biogen Idec declined to confirm or deny the existence of the e-mail and said the company would not comment on individual patient cases. She said experts were examining the records of all patients who took the drug and would compile a complete report, which might be ready by the end of summer.

The medical journal's papers provided details on the first three patients. Doctors in Belgium looked at stored blood samples taken over time from one patient who died from P.M.L.

P.M.L. is caused by the JC virus, which is present in most people but lies dormant in the kidneys or lymph nodes. It is thought that Tysabri weakens the immune system, which, allows the virus to become active.

The Belgian researchers found that the JC virus was present in the blood, perhaps a precursor to entering the brain, two months before the patient was admitted to the hospital with symptoms of the disease.

A second paper, by doctors at Stanford and the University of California, San Francisco, reported on a patient who now appears to be recovering from P.M.L.

Biogen executives said in a letter to the medical journal that, taken together, those observations suggested it might be possible to monitor patients closely and then stop the drug if the virus is detected in the blood in time to avert serious consequences. Biogen is now analyzing blood samples from the other patients to see if they, too, had JC virus in their blood well before the onset of P.M.L. symptoms.

But Dr. Joseph R. Berger of the University of Kentucky, the co-author of an editorial in the medical journal, said, "We don't know if simply stopping the drug once the virus is observed is going to prevent development of the disease."

Dr. Berger, a consultant to Biogen and many of its competitors, said evidence from the papers suggested that the drug continues to have an effect up to three months after the last dose. Moreover, he said, there is no good treatment for P.M.L. Even if the disease is not fatal, patients can be left with problems. The patient in California is now at a rehabilitation center but still cannot walk, said Dr. Annette Langer-Gould of Stanford, an author of the paper.

Moreover, when Tysabri wore off three months after the last dose, the patient's immune system went into overdrive, causing severe inflammation that nearly killed him.

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link for complete storyResearchers suggest that increased levels of immune antibodies that fight Epstein-Barr Virus (EBV), the virus that causes infectious mononucleosis and other disorders, may be associated with an increased risk of developing multiple sclerosis. Alberto Ascherio, MD, DrPH, and colleagues (Harvard School of Public Health, Walter Reed Army Institute of Research) originally reported their findings in the March 26, 2003 Journal of the American Medical Association. However, due to an error in the processing of the data, the authors have retracted the original article and published a revised report in the May 25, 2005 Journal of the American Medical Association. The revised report still found a relationship between EBV and risk of developing MS but that this relationship was age dependent.

LINK....FREE REGISTRATION REQUIREDIf the fourth case of the normally extremely rare infection is confirmed, it would make it more difficult for the drug to return to the market, doctors and analysts said. The new case might indicate the drug is more dangerous than previously thought because it appears the fourth patient might have taken the drug for a substantially shorter time than the other three.

Mr. McGlynn of Elan said the patient with the new possible case was not someone who had participated in clinical trials of the drug, as the other three confirmed P.M.L. patients had done. That would suggest the person would have received only a few monthly doses at most, since the drug was not generally available before November.

"If this someone who got three or four doses that would be a major concern," said Dr. Patricia K. Coyle, a professor and the acting chairwoman of neurology at SUNY Stony Brook.

The first two patients had taken Tysabri, in combination with Avonex, another multiple sclerosis drug from Biogen for more than two years. The third patient, who had Crohn's disease, had received 8 doses of Tysabri over 18 months and had not taken Avonex

CLICK FOR FULL STORYThe Food and Drug Administration (FDA) confirmed it was reviewing a link between Tysabri and a possible case of the rare brain infection PML. "The case is being reviewed," FDA spokeswoman Lenore Gelb said.

The Boston Globe reported earlier that Biogen, with which Elan developed the treatment, had told the FDA a fourth patient may have contracted PML.