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Issue: #11November 2012

MSResearchUpdateMS Research Update

 

MS relapse rates increase after infertility treatment

 

A recent study identified a link between multiple sclerosis (MS) activity and assisted reproduction technology (ART) infertility treatment. Researchers found that patients with relapsing-remitting MS who had just one ART treatment were 7 times more likely to have a relapse and 9 times more likely to have enhanced disease activity on an MRI. Risks increased with more than one ART cycle, with a 14- and 20-fold relapse risk after 2nd and 3rd ART cycles, respectively.

 

In total, 16 patients were monitored over 26 ART cycles. Every three months they received neurological exams, brain MRIs and immunology testing. Researchers also monitored other specific signals of immune function and reproductive health.

 

The study concludes that ART is associated with a significant increase in MS disease activity. Further, reproductive hormones appear to be important in regulating immune responses during the course of autoimmune diseases. Read the full abstract.

 

Comments:

 

In this study, MS relapse rates increased regardless of whether ART resulted in pregnancy or not. Interestingly though, the increase in relapse was very similar to what women commonly experience in the three months after having a baby. Such relapses are believed to be caused by hormonal changes that affect the immune system.

 

The report clarifies the MS relapse risk following ART that incorporates gonadotropin-releasing hormone (GnRH) agonists, which temporarily lower estrogen in women. However, the risk following GnRH antagonist use remains less established. A study published using French national registry suggests that using GnRH antagonist did not increase risk of MS relapse--which may be another option for couples trying to get pregnant. However, the same study noted that women were less likely to become pregnant using GnRH antagonist (10%) than with GnRH agonists (40%).

 

Although MS and most of MS treatments alone do not affect fertility, 10-20 percent of all American couples have difficulty having a baby and may consider some form of ART. MS patients should be aware of the increased risk of MS relapse following ART and discuss this with their health care provider before starting an infertility treatment. 

 

 

  

Pavle Repovic, M.D., Ph.D.
Neurologist

Multiple Sclerosis Center at Swedish Neurosciences Institute

 

DrQianUpcoming MS Series on Everyday Health 

 

 

In early November, Dr. James Bowen and Bobbie Severson, advanced registered nurse practitioner, joined chef and blogger Trevis Gleason to shoot a series videos about living with MS.

 

Just in time for the holidays, Trevis will introduce the series with a video on cooking with fatigue and discussion about managing symptoms with Dr. Bowen. Each of the videos to follow will feature individuals sharing their journey with MS--changing careers, parenting, multi-generational MS and more--and discussions about health with experts from Swedish.

 

The videos will released beginning later this month on Everyday Health, a leading provider of online health information.

 

MSCenterResearchMS Center Research

 

New Trial Examines B-Cell Medication

 

The MS Center began a clinical trial in November for an experimental medication to treat relapsing-remitting multiple sclerosis. MEDI-551, the medication in the study, specifically reduces the number of CD-19 B-cells in the blood. A reduction in the number of B-cells has been associated with a lower relapse rate and improvement in symptoms of MS. Researchers believe medications targeting this subset of B-cells may have a better safety profile than other MS medications that target CD-20 b-cells.

 

MEDI-551 is made of a human monoclonal antibody that targets B cells. Like an antibody made naturally by the immune system, monoclonal antibody is a man-made protein that helps fight infection. The phase I clinical trial aims to determine whether MEDI-551 will be a safe and effective to treat MS.

 

Learn more about our research and clinical trials, or call an MS Center research coordinator at (206) 320-2200.
 

NewCenterOpenMS Center Highlight

MS Center Opens Gym to Patients December 3

 

The MS Center will begin offering free access to the MS Center gym to patients once per week. Patients can sign up for a time between 8:30am - 12:30pm to work out in the gym on Mondays beginning in December. MS Center staff will be available to help patients with equipment and answer questions about their fitness routine. 

 

For patient convenience, popular equipment will be by sign-up only. To schedule your gym time, contact Janice or Mike at 206-320-2200. 

 

MSNewsMS News Digest

This year at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), neurologists at the MS Center learned results from new studies and presentations from MS experts worldwide. Below are a few findings from this year's conference:

 

Statins may prevent brain atrophy secondary-progressive MS

Statins are commonly used to help lower cholesterol, and have reduced heart disease hospitalizations and deaths. Dr. Jeremy Chataway of University College London presented findings that found a particular statin called simvastin may also protect against nervous system damage and even help repair myelin. The phase II, two-year study examined 140 people with secondary progressive MS while taking either placebo or high-dose (80mg) simvastatin. After two years, the study found that participants who took simvastatin had nearly 40 percent less brain atrophy and showed less progression of their disease. Further studies will be needed to learn more about the effects of simvastatin in MS. Read the abstract.

 

Second phase III study show reduced relapse risks and disability progression with teriflunomide

Dr. Ludwig Kappos of the University of Basel presented results of the Teriflunomide Oral in people With relapsing remitting multiplE scleRosis (TOWER) study. Participants who took 14mg of teriflunomide compared to placebo were 36.3 percent less likely to relapse and their risk of disability decreased 31.5 percent. Those taking 7mg of teriflunomide were 22.3 percent less likely to relapse, but there was no significant decrease in disability progression. The US FDA approved teriflunomide (Aubagio�) to treat MS in September. Read the abstract.

 

Gut bacteria may affect immunity

Dr. Lloyd Kasper of Dartmouth University presented data from a study of a molecule called polysaccharide A (PSA), a specific bacteria produced by the intestines, and its potential implications for MS. When given orally to mice, the study reported that PSA reduced the effects of experimental autoimmune encephalomyelitis (EAE), an MS-like disease in animals. PSA also stimulated regulatory cells normally impaired in MS patients. PSA can stimulate these cells in lab dishes, creating an anti-inflammatory response in the immune system. Research will be needed to learn more about PSA's effects on humans with MS. Read the abstract.

 

MSEventsMS Center Events

For questions or to register, contact Kate Floyd, 206.991.2099. 

 

Music Therapy - Special Session Nov. 29

2:30-3:30pm | MS Center at Swedish

The MS Center partners with Seattle Pacific University to bring music therapy to the Center. Classes are free and open to non-Swedish patients and caregivers/partners. Classes will resume in the MS Center on Thursdays, beginning January 10, 2013.


Gentle Yoga

Tuesdays, Oct. 23-Dec. 4 | 11:30-1pm | MS Center at Swedish

The MS Center hosts yoga classes taught by trained instructor, Cyndi Kershner, of Full Circle Yoga Arts. Classes are free and open to non-Swedish patients and caregivers/partners.

 

Stretch and Strengthen Yoga

Thursdays, Oct. 25-Dec. 20 | 5:30-7pm | MS Center at Swedish

For participants wanting more of a workout in their yoga routine, and are able to stand for long periods and transfer to and from the floor without assistance. $12/class or $60/series  

 

Gym Hours Begin Dec. 3

Mondays, 8:30am-12:30pm | MS Center at Swedish | Free

The MS Center gym is open Monday mornings. Participants must schedule their gym time in advance of arrival. For more information and to sign up, call Janice or Mike at 206.320.2200. Free.

 

Tacoma MS Road Show  - Save the Date!

February 1, 2013 | 12:30-5pm | Courtyard Marriot  Downtown, Tacoma (map)

You are invited to listen and learn from MS experts at the Swedish Neuroscience Institute.

Visit the MS Center Programs page to learn more and register. Free.

 swedish.org/ms