ICYMI Multiple Sclerosis

Key clinical point: Although injectables are the most frequently used disease-modifying agents (DMAs) for multiple sclerosis (MS), the utilization of oral DMAs is increasing.

Major finding: Between 2006 and 2015, DMAs were prescribed in 45% of MS visits. Although injectables remain the most commonly prescribed DMAs (78%), the use of oral DMAs has increased (from 11% in 2010-2011 to 40% in 2014-2015) and that of injectable DMAs has decreased (from 96% in 2006-2007 to 52% in 2014-2015). Visiting a neurologist was the strongest predictor of DMA use (odds ratio, 6.61; 95% CI, 3.66-11.93). 

Study details: A cross-sectional study examined the prescribing patterns and trends of DMAs in the US using the 2006-2015 National Ambulatory Medical Care Survey.

Disclosures: The study was not funded. George Hutton and Rajender Aparasu reported receiving grants from multiple pharmaceutical companies outside the submitted work. The remaining authors declared no conflicts of interest. 

Citation: Earla JR et al. Res Social Adm Pharm. 2020 Mar 11. doi: 10.1016/j.sapharm.2020.02.016. 

Key clinical point: Although injectables are the most frequently used disease-modifying agents (DMAs) for multiple sclerosis (MS), the utilization of oral DMAs is increasing.

Major finding: Between 2006 and 2015, DMAs were prescribed in 45% of MS visits. Although injectables remain the most commonly prescribed DMAs (78%), the use of oral DMAs has increased (from 11% in 2010-2011 to 40% in 2014-2015) and that of injectable DMAs has decreased (from 96% in 2006-2007 to 52% in 2014-2015). Visiting a neurologist was the strongest predictor of DMA use (odds ratio, 6.61; 95% CI, 3.66-11.93). 

Study details: A cross-sectional study examined the prescribing patterns and trends of DMAs in the US using the 2006-2015 National Ambulatory Medical Care Survey.

Disclosures: The study was not funded. George Hutton and Rajender Aparasu reported receiving grants from multiple pharmaceutical companies outside the submitted work. The remaining authors declared no conflicts of interest. 

Citation: Earla JR et al. Res Social Adm Pharm. 2020 Mar 11. doi: 10.1016/j.sapharm.2020.02.016. 

Key clinical point: Although injectables are the most frequently used disease-modifying agents (DMAs) for multiple sclerosis (MS), the utilization of oral DMAs is increasing.

Major finding: Between 2006 and 2015, DMAs were prescribed in 45% of MS visits. Although injectables remain the most commonly prescribed DMAs (78%), the use of oral DMAs has increased (from 11% in 2010-2011 to 40% in 2014-2015) and that of injectable DMAs has decreased (from 96% in 2006-2007 to 52% in 2014-2015). Visiting a neurologist was the strongest predictor of DMA use (odds ratio, 6.61; 95% CI, 3.66-11.93). 

Study details: A cross-sectional study examined the prescribing patterns and trends of DMAs in the US using the 2006-2015 National Ambulatory Medical Care Survey.

Disclosures: The study was not funded. George Hutton and Rajender Aparasu reported receiving grants from multiple pharmaceutical companies outside the submitted work. The remaining authors declared no conflicts of interest. 

Citation: Earla JR et al. Res Social Adm Pharm. 2020 Mar 11. doi: 10.1016/j.sapharm.2020.02.016. 

The Food and Drug Administration has approved the oral medication ozanimod (Zeposia) for relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, according to a release from Bristol-Myers Squibb.

Ozanimod is a sphingosine 1-phosphate (S1P) receptor modulator that binds with high affinity to S1P receptors 1 and 5. It blocks the capacity of lymphocytes to egress from lymph nodes, reducing the number of lymphocytes in peripheral blood. Although its therapeutic mechanism of action in MS is unknown, it may involve the reduction of lymphocyte migration into the central nervous system. A genetic test is not required to start the drug, and no patient observation is required for the first dose, although up-titration of initial doses are required to reach the maintenance dose because a transient decrease in heart rate and atrioventricular conduction delays may occur, according to the company.

The approval is based on a pair of head-to-head studies that compared it with interferon beta-1a (Avonex) and together included more than 2,600 patients. It delivered better efficacy in terms of relative reduction in annualized relapse rate (48% at 1 year and 38% at 2 years). It also demonstrated better relative reduction of the number of T1-weighted gadolinium-enhanced brain lesions (63% fewer at 1 year and 53% fewer at 2 years) and number of new or enlarging T2 lesions (48% fewer at 1 year and 42% at 2 years).

Ozanimod is contraindicated in patients who, in the past 6 months, experienced a myocardial infarction, unstable angina, stroke, or other conditions. It is associated with other health risks, including infections, liver injury, additive immunosuppressive effects from prior immune-modulating therapies, and increased blood pressure. Certain assessments, such as recent complete blood count, ECG, liver function test, and current and prior medications and vaccinations, are required before initiation of treatment.

In its announcement, Bristol-Myers Squibb said that it has decided to delay the commercial launch of ozanimod during the COVID-19 pandemic until a later date.

The drug is also in development for additional immune-inflammatory indications, including ulcerative colitis and Crohn’s disease.

The full prescribing information can be found on the company’s website.

[email protected]

The Food and Drug Administration has approved the oral medication ozanimod (Zeposia) for relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, according to a release from Bristol-Myers Squibb.

Ozanimod is a sphingosine 1-phosphate (S1P) receptor modulator that binds with high affinity to S1P receptors 1 and 5. It blocks the capacity of lymphocytes to egress from lymph nodes, reducing the number of lymphocytes in peripheral blood. Although its therapeutic mechanism of action in MS is unknown, it may involve the reduction of lymphocyte migration into the central nervous system. A genetic test is not required to start the drug, and no patient observation is required for the first dose, although up-titration of initial doses are required to reach the maintenance dose because a transient decrease in heart rate and atrioventricular conduction delays may occur, according to the company.

The approval is based on a pair of head-to-head studies that compared it with interferon beta-1a (Avonex) and together included more than 2,600 patients. It delivered better efficacy in terms of relative reduction in annualized relapse rate (48% at 1 year and 38% at 2 years). It also demonstrated better relative reduction of the number of T1-weighted gadolinium-enhanced brain lesions (63% fewer at 1 year and 53% fewer at 2 years) and number of new or enlarging T2 lesions (48% fewer at 1 year and 42% at 2 years).

Ozanimod is contraindicated in patients who, in the past 6 months, experienced a myocardial infarction, unstable angina, stroke, or other conditions. It is associated with other health risks, including infections, liver injury, additive immunosuppressive effects from prior immune-modulating therapies, and increased blood pressure. Certain assessments, such as recent complete blood count, ECG, liver function test, and current and prior medications and vaccinations, are required before initiation of treatment.

In its announcement, Bristol-Myers Squibb said that it has decided to delay the commercial launch of ozanimod during the COVID-19 pandemic until a later date.

The drug is also in development for additional immune-inflammatory indications, including ulcerative colitis and Crohn’s disease.

The full prescribing information can be found on the company’s website.

[email protected]

The Food and Drug Administration has approved the oral medication ozanimod (Zeposia) for relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, according to a release from Bristol-Myers Squibb.

Ozanimod is a sphingosine 1-phosphate (S1P) receptor modulator that binds with high affinity to S1P receptors 1 and 5. It blocks the capacity of lymphocytes to egress from lymph nodes, reducing the number of lymphocytes in peripheral blood. Although its therapeutic mechanism of action in MS is unknown, it may involve the reduction of lymphocyte migration into the central nervous system. A genetic test is not required to start the drug, and no patient observation is required for the first dose, although up-titration of initial doses are required to reach the maintenance dose because a transient decrease in heart rate and atrioventricular conduction delays may occur, according to the company.

The approval is based on a pair of head-to-head studies that compared it with interferon beta-1a (Avonex) and together included more than 2,600 patients. It delivered better efficacy in terms of relative reduction in annualized relapse rate (48% at 1 year and 38% at 2 years). It also demonstrated better relative reduction of the number of T1-weighted gadolinium-enhanced brain lesions (63% fewer at 1 year and 53% fewer at 2 years) and number of new or enlarging T2 lesions (48% fewer at 1 year and 42% at 2 years).

Ozanimod is contraindicated in patients who, in the past 6 months, experienced a myocardial infarction, unstable angina, stroke, or other conditions. It is associated with other health risks, including infections, liver injury, additive immunosuppressive effects from prior immune-modulating therapies, and increased blood pressure. Certain assessments, such as recent complete blood count, ECG, liver function test, and current and prior medications and vaccinations, are required before initiation of treatment.

In its announcement, Bristol-Myers Squibb said that it has decided to delay the commercial launch of ozanimod during the COVID-19 pandemic until a later date.

The drug is also in development for additional immune-inflammatory indications, including ulcerative colitis and Crohn’s disease.

The full prescribing information can be found on the company’s website.

[email protected]

Key clinical point: In patients with multiple sclerosis (MS), N-acetyl cysteine (NAC) positively affects cerebral glucose metabolism, and this appears to be associated with improved symptoms related to cognition and attention.

Major finding: Based on fluorodeoxyglucose (FDG) positron emission tomography (PET) data, NAC group vs. the control group demonstrated significant increases in cerebral glucose metabolism after therapy in several brain regions including the lateral and middle temporal lobes, inferior frontal lobe, and caudate (P less than .05). NAC group had significant improvements in self-reported scores related to cognition and attention.

Study details: Twenty-four patients with a diagnosis of MS were randomly assigned to NAC plus standard of care or standard of care only (waitlist control group). FDG PET was used to assess cerebral glucose metabolism at baseline and after 2 months in all patients.

Disclosures: This study was supported by a grant from the Coors Foundation. The authors declared no potential conflicts of interest.

Citation: Monti DA et al. Front Neurol. 2020 Feb 14. doi: 10.3389/fneur.2020.00088.

Key clinical point: In patients with multiple sclerosis (MS), N-acetyl cysteine (NAC) positively affects cerebral glucose metabolism, and this appears to be associated with improved symptoms related to cognition and attention.

Major finding: Based on fluorodeoxyglucose (FDG) positron emission tomography (PET) data, NAC group vs. the control group demonstrated significant increases in cerebral glucose metabolism after therapy in several brain regions including the lateral and middle temporal lobes, inferior frontal lobe, and caudate (P less than .05). NAC group had significant improvements in self-reported scores related to cognition and attention.

Study details: Twenty-four patients with a diagnosis of MS were randomly assigned to NAC plus standard of care or standard of care only (waitlist control group). FDG PET was used to assess cerebral glucose metabolism at baseline and after 2 months in all patients.

Disclosures: This study was supported by a grant from the Coors Foundation. The authors declared no potential conflicts of interest.

Citation: Monti DA et al. Front Neurol. 2020 Feb 14. doi: 10.3389/fneur.2020.00088.

Key clinical point: In patients with multiple sclerosis (MS), N-acetyl cysteine (NAC) positively affects cerebral glucose metabolism, and this appears to be associated with improved symptoms related to cognition and attention.

Major finding: Based on fluorodeoxyglucose (FDG) positron emission tomography (PET) data, NAC group vs. the control group demonstrated significant increases in cerebral glucose metabolism after therapy in several brain regions including the lateral and middle temporal lobes, inferior frontal lobe, and caudate (P less than .05). NAC group had significant improvements in self-reported scores related to cognition and attention.

Study details: Twenty-four patients with a diagnosis of MS were randomly assigned to NAC plus standard of care or standard of care only (waitlist control group). FDG PET was used to assess cerebral glucose metabolism at baseline and after 2 months in all patients.

Disclosures: This study was supported by a grant from the Coors Foundation. The authors declared no potential conflicts of interest.

Citation: Monti DA et al. Front Neurol. 2020 Feb 14. doi: 10.3389/fneur.2020.00088.

Key clinical point: Diet quality is not associated with the risk for late-onset multiple sclerosis (MS) in middle-aged individuals.

Major finding: Diet quality, assessed by means of the Alternative Healthy Eating Index-2010, was not statistically significantly associated with late-onset MS diagnosis risk (hazard ratio highest vs. lowest tertile, 0.79; test for trend: P = .22). Smoking did not modify the association.

Study details: Prospective cohort study based on the Danish cohort “Diet, Cancer and Health” evaluated the association between diet quality and the hazards of late-onset MS diagnosis in 56,867 individuals (age, 50-64 years) who were followed for a median of 20.4 years; 124 patients with MS were identified.

Disclosures: This study did not receive any specific funding. The data collection for the Diet, Cancer and Health cohort was funded by the Danish Cancer Society. Ulrik Dalgas has received research support, travel grants, and/or teaching honorary from Biogen Idec, Merck Serono, Novartis, Bayer Schering, and Sanofi Aventis as well as honoraria from serving on scientific advisory boards of Biogen Idec and Genzyme. The other authors reported no conflicts of interest.

Citation: Pommerich UM et al. Mult Scler Relat Disord. 2020 Jan 26. doi: 10.1016/j.msard.2020.101968. 

Key clinical point: Diet quality is not associated with the risk for late-onset multiple sclerosis (MS) in middle-aged individuals.

Major finding: Diet quality, assessed by means of the Alternative Healthy Eating Index-2010, was not statistically significantly associated with late-onset MS diagnosis risk (hazard ratio highest vs. lowest tertile, 0.79; test for trend: P = .22). Smoking did not modify the association.

Study details: Prospective cohort study based on the Danish cohort “Diet, Cancer and Health” evaluated the association between diet quality and the hazards of late-onset MS diagnosis in 56,867 individuals (age, 50-64 years) who were followed for a median of 20.4 years; 124 patients with MS were identified.

Disclosures: This study did not receive any specific funding. The data collection for the Diet, Cancer and Health cohort was funded by the Danish Cancer Society. Ulrik Dalgas has received research support, travel grants, and/or teaching honorary from Biogen Idec, Merck Serono, Novartis, Bayer Schering, and Sanofi Aventis as well as honoraria from serving on scientific advisory boards of Biogen Idec and Genzyme. The other authors reported no conflicts of interest.

Citation: Pommerich UM et al. Mult Scler Relat Disord. 2020 Jan 26. doi: 10.1016/j.msard.2020.101968. 

Key clinical point: Diet quality is not associated with the risk for late-onset multiple sclerosis (MS) in middle-aged individuals.

Major finding: Diet quality, assessed by means of the Alternative Healthy Eating Index-2010, was not statistically significantly associated with late-onset MS diagnosis risk (hazard ratio highest vs. lowest tertile, 0.79; test for trend: P = .22). Smoking did not modify the association.

Study details: Prospective cohort study based on the Danish cohort “Diet, Cancer and Health” evaluated the association between diet quality and the hazards of late-onset MS diagnosis in 56,867 individuals (age, 50-64 years) who were followed for a median of 20.4 years; 124 patients with MS were identified.

Disclosures: This study did not receive any specific funding. The data collection for the Diet, Cancer and Health cohort was funded by the Danish Cancer Society. Ulrik Dalgas has received research support, travel grants, and/or teaching honorary from Biogen Idec, Merck Serono, Novartis, Bayer Schering, and Sanofi Aventis as well as honoraria from serving on scientific advisory boards of Biogen Idec and Genzyme. The other authors reported no conflicts of interest.

Citation: Pommerich UM et al. Mult Scler Relat Disord. 2020 Jan 26. doi: 10.1016/j.msard.2020.101968. 

Key clinical point: Increase in leptin concentration is associated with an elevated multiple sclerosis (MS) risk among young individuals.

Major finding: A 1-unit increase in leptin z-score was associated with higher MS risk in individuals younger than 20 years (odds ratio [OR], 1.4; 95% confidence interval, 1.1-1.9) and in all men (OR, 1.4; 95% confidence interval, 1.0-2.0). In contrast, MS risk reduced with increased leptin levels in women aged 30-39 years after adjustment for insulin levels (OR, 0.74; 95% confidence interval, 0.54-1.0).

Study details: This nested case-control study used blood samples from Swedish biobanks and compared leptin and insulin concentrations in 649 individuals who later developed relapsing-remitting MS and 649 matched controls.

Disclosures: This study was supported by the Swedish Research Council. Lucia Alonso-Magdalena has received speaking fees from Merck Serono and served on advisory board for Merck Serono and Biogen. Magnus Vrethem has received honoraria for lectures from Genzyme and for advisory boards from Roche and Novartis. 

Citation: Biström M et al. Mult Scler. 2020 Feb 7. doi: 10.1177/1352458520905033.

Key clinical point: Increase in leptin concentration is associated with an elevated multiple sclerosis (MS) risk among young individuals.

Major finding: A 1-unit increase in leptin z-score was associated with higher MS risk in individuals younger than 20 years (odds ratio [OR], 1.4; 95% confidence interval, 1.1-1.9) and in all men (OR, 1.4; 95% confidence interval, 1.0-2.0). In contrast, MS risk reduced with increased leptin levels in women aged 30-39 years after adjustment for insulin levels (OR, 0.74; 95% confidence interval, 0.54-1.0).

Study details: This nested case-control study used blood samples from Swedish biobanks and compared leptin and insulin concentrations in 649 individuals who later developed relapsing-remitting MS and 649 matched controls.

Disclosures: This study was supported by the Swedish Research Council. Lucia Alonso-Magdalena has received speaking fees from Merck Serono and served on advisory board for Merck Serono and Biogen. Magnus Vrethem has received honoraria for lectures from Genzyme and for advisory boards from Roche and Novartis. 

Citation: Biström M et al. Mult Scler. 2020 Feb 7. doi: 10.1177/1352458520905033.

Key clinical point: Increase in leptin concentration is associated with an elevated multiple sclerosis (MS) risk among young individuals.

Major finding: A 1-unit increase in leptin z-score was associated with higher MS risk in individuals younger than 20 years (odds ratio [OR], 1.4; 95% confidence interval, 1.1-1.9) and in all men (OR, 1.4; 95% confidence interval, 1.0-2.0). In contrast, MS risk reduced with increased leptin levels in women aged 30-39 years after adjustment for insulin levels (OR, 0.74; 95% confidence interval, 0.54-1.0).

Study details: This nested case-control study used blood samples from Swedish biobanks and compared leptin and insulin concentrations in 649 individuals who later developed relapsing-remitting MS and 649 matched controls.

Disclosures: This study was supported by the Swedish Research Council. Lucia Alonso-Magdalena has received speaking fees from Merck Serono and served on advisory board for Merck Serono and Biogen. Magnus Vrethem has received honoraria for lectures from Genzyme and for advisory boards from Roche and Novartis. 

Citation: Biström M et al. Mult Scler. 2020 Feb 7. doi: 10.1177/1352458520905033.

Key clinical point: Concussions in adolescents correlate to an elevated risk for multiple sclerosis (MS).

Major finding: The risk for MS was higher among patients exposed to a concussion in adolescence (hazard ratio [HR], 1.29; P = .03). Sex-specific analysis revealed a higher risk for MS only in males who sustained a concussion in adolescence (HR, 1.41; P = 0.04).

Study details: Retrospective study included 97,965 patients (age, 11-18 years) exposed to a concussion who were matched to 293,895 unexposed patients; primary outcome was MS diagnosis.

Disclosures: This study was funded by an unrestricted investigator-initiated trial grant from Roche Canada and supported by ICES. The corresponding author has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis, and Roche; has received Investigator Initiated Grant Funds from Biogen Idec, Novartis, and Roche; and has acted as site PI for multicenter trials funded by Novartis, Genzyme, Roche, and AbbVie. All other authors declared no conflicts of interest.

Citation: Povolo CA et al. Mult Scler. 2020 Feb 24. doi: 10.1177/1352458520908037. 

Key clinical point: Concussions in adolescents correlate to an elevated risk for multiple sclerosis (MS).

Major finding: The risk for MS was higher among patients exposed to a concussion in adolescence (hazard ratio [HR], 1.29; P = .03). Sex-specific analysis revealed a higher risk for MS only in males who sustained a concussion in adolescence (HR, 1.41; P = 0.04).

Study details: Retrospective study included 97,965 patients (age, 11-18 years) exposed to a concussion who were matched to 293,895 unexposed patients; primary outcome was MS diagnosis.

Disclosures: This study was funded by an unrestricted investigator-initiated trial grant from Roche Canada and supported by ICES. The corresponding author has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis, and Roche; has received Investigator Initiated Grant Funds from Biogen Idec, Novartis, and Roche; and has acted as site PI for multicenter trials funded by Novartis, Genzyme, Roche, and AbbVie. All other authors declared no conflicts of interest.

Citation: Povolo CA et al. Mult Scler. 2020 Feb 24. doi: 10.1177/1352458520908037. 

Key clinical point: Concussions in adolescents correlate to an elevated risk for multiple sclerosis (MS).

Major finding: The risk for MS was higher among patients exposed to a concussion in adolescence (hazard ratio [HR], 1.29; P = .03). Sex-specific analysis revealed a higher risk for MS only in males who sustained a concussion in adolescence (HR, 1.41; P = 0.04).

Study details: Retrospective study included 97,965 patients (age, 11-18 years) exposed to a concussion who were matched to 293,895 unexposed patients; primary outcome was MS diagnosis.

Disclosures: This study was funded by an unrestricted investigator-initiated trial grant from Roche Canada and supported by ICES. The corresponding author has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis, and Roche; has received Investigator Initiated Grant Funds from Biogen Idec, Novartis, and Roche; and has acted as site PI for multicenter trials funded by Novartis, Genzyme, Roche, and AbbVie. All other authors declared no conflicts of interest.

Citation: Povolo CA et al. Mult Scler. 2020 Feb 24. doi: 10.1177/1352458520908037. 

Key clinical point: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with early relapsing multiple sclerosis (MS).

Major finding: Each 25 nmol/L increase in serum 25(OH)D levels is associated with a decrease in clinical relapse rate (risk ratio [RR], 0.90), gadolinium-enhancing lesions (RR, 0.69), new/enlarging T2 lesions (RR, 0.86), and new active lesions (RR, 0.81) in the magnetic resonance imaging. 

Study details: Meta-analysis of 13 studies including 3,498 patients.

Disclosures: No study sponsor was identified.

Citation: Martínez-Lapiscina EH et al. J Neurol Sci. 2020 Jan 25. doi: 10.1016/j.jns.2020.116668.

Key clinical point: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with early relapsing multiple sclerosis (MS).

Major finding: Each 25 nmol/L increase in serum 25(OH)D levels is associated with a decrease in clinical relapse rate (risk ratio [RR], 0.90), gadolinium-enhancing lesions (RR, 0.69), new/enlarging T2 lesions (RR, 0.86), and new active lesions (RR, 0.81) in the magnetic resonance imaging. 

Study details: Meta-analysis of 13 studies including 3,498 patients.

Disclosures: No study sponsor was identified.

Citation: Martínez-Lapiscina EH et al. J Neurol Sci. 2020 Jan 25. doi: 10.1016/j.jns.2020.116668.

Key clinical point: Serum 25(OH)D levels are associated with a modest decrease in relapse rate and radiological inflammatory activities in patients with early relapsing multiple sclerosis (MS).

Major finding: Each 25 nmol/L increase in serum 25(OH)D levels is associated with a decrease in clinical relapse rate (risk ratio [RR], 0.90), gadolinium-enhancing lesions (RR, 0.69), new/enlarging T2 lesions (RR, 0.86), and new active lesions (RR, 0.81) in the magnetic resonance imaging. 

Study details: Meta-analysis of 13 studies including 3,498 patients.

Disclosures: No study sponsor was identified.

Citation: Martínez-Lapiscina EH et al. J Neurol Sci. 2020 Jan 25. doi: 10.1016/j.jns.2020.116668.

Key clinical point: A significant proportion of patients with multiple sclerosis (MS) and spasticity from Oregon, US reported cannabis use and found it beneficial for their pain and spasticity.

Major finding: Among the patients assessed, 54% reported using cannabis in the past and 36% reported current use of cannabis. For the treatment of spasticity, 26% of patients used both prescribed medications and cannabis. Among current users, 85% and 79% of patients reported cannabis being somewhat to very helpful for pain and spasticity, respectively.

Study details: A cross-sectional study evaluated the cannabis use and its perceived benefits among patients with MS and self-reported spasticity (n = 91) who were enrolled in a randomized controlled trial for MS-related spasticity in Oregon, US.

Disclosures: The study was supported by the VA Office of Research and Development via Rehabilitation Research and Development. Dr. Rice reported consulting for Greenwich Biosciences. Dr. Cameron reported consulting for Adamas Pharmaceuticals Inc. and Greenwich Biosciences. Ms. Hugos and Ms. Hildebrand declared no conflict of interest.

Citation: Rice J et al. Mult Scler Relat Disord. 2020 Feb 11. doi: 10.1016/j.msard.2020.102009.

Key clinical point: A significant proportion of patients with multiple sclerosis (MS) and spasticity from Oregon, US reported cannabis use and found it beneficial for their pain and spasticity.

Major finding: Among the patients assessed, 54% reported using cannabis in the past and 36% reported current use of cannabis. For the treatment of spasticity, 26% of patients used both prescribed medications and cannabis. Among current users, 85% and 79% of patients reported cannabis being somewhat to very helpful for pain and spasticity, respectively.

Study details: A cross-sectional study evaluated the cannabis use and its perceived benefits among patients with MS and self-reported spasticity (n = 91) who were enrolled in a randomized controlled trial for MS-related spasticity in Oregon, US.

Disclosures: The study was supported by the VA Office of Research and Development via Rehabilitation Research and Development. Dr. Rice reported consulting for Greenwich Biosciences. Dr. Cameron reported consulting for Adamas Pharmaceuticals Inc. and Greenwich Biosciences. Ms. Hugos and Ms. Hildebrand declared no conflict of interest.

Citation: Rice J et al. Mult Scler Relat Disord. 2020 Feb 11. doi: 10.1016/j.msard.2020.102009.

Key clinical point: A significant proportion of patients with multiple sclerosis (MS) and spasticity from Oregon, US reported cannabis use and found it beneficial for their pain and spasticity.

Major finding: Among the patients assessed, 54% reported using cannabis in the past and 36% reported current use of cannabis. For the treatment of spasticity, 26% of patients used both prescribed medications and cannabis. Among current users, 85% and 79% of patients reported cannabis being somewhat to very helpful for pain and spasticity, respectively.

Study details: A cross-sectional study evaluated the cannabis use and its perceived benefits among patients with MS and self-reported spasticity (n = 91) who were enrolled in a randomized controlled trial for MS-related spasticity in Oregon, US.

Disclosures: The study was supported by the VA Office of Research and Development via Rehabilitation Research and Development. Dr. Rice reported consulting for Greenwich Biosciences. Dr. Cameron reported consulting for Adamas Pharmaceuticals Inc. and Greenwich Biosciences. Ms. Hugos and Ms. Hildebrand declared no conflict of interest.

Citation: Rice J et al. Mult Scler Relat Disord. 2020 Feb 11. doi: 10.1016/j.msard.2020.102009.

Key clinical point: The personalized multidisciplinary rehabilitation (PMDR) approach can improve highly impacting symptoms in patients with relapse-onset multiple sclerosis (MS) and have a positive influence on their quality of life.

Major finding: Patients receiving PMDR had a reduction in perceived fatigue and improvement of walking abilities and health-related quality of life compared with control individuals. Improved performance on a motor sequence learning task in terms of accuracy was observed after rehabilitation. All improvements persisted at the 4-week follow-up. 

Study details: A longitudinal parallel group study included 24 patients with relapse-onset MS, who received a 4-week PMDR, and 24 control individuals. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Athina Papadopoulou, Laura Gaetano, Katrin Parmar, Thierry Ettlin, Corina Schuster-Amft, Jens Wuerfel, Ludwig Kappos, Till Sprenger, and Stefano Magon reported receiving research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Zuber P et al. J Neurol. 2020 Mar 2. doi: 10.1007/s00415-020-09768-6.

Key clinical point: The personalized multidisciplinary rehabilitation (PMDR) approach can improve highly impacting symptoms in patients with relapse-onset multiple sclerosis (MS) and have a positive influence on their quality of life.

Major finding: Patients receiving PMDR had a reduction in perceived fatigue and improvement of walking abilities and health-related quality of life compared with control individuals. Improved performance on a motor sequence learning task in terms of accuracy was observed after rehabilitation. All improvements persisted at the 4-week follow-up. 

Study details: A longitudinal parallel group study included 24 patients with relapse-onset MS, who received a 4-week PMDR, and 24 control individuals. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Athina Papadopoulou, Laura Gaetano, Katrin Parmar, Thierry Ettlin, Corina Schuster-Amft, Jens Wuerfel, Ludwig Kappos, Till Sprenger, and Stefano Magon reported receiving research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Zuber P et al. J Neurol. 2020 Mar 2. doi: 10.1007/s00415-020-09768-6.

Key clinical point: The personalized multidisciplinary rehabilitation (PMDR) approach can improve highly impacting symptoms in patients with relapse-onset multiple sclerosis (MS) and have a positive influence on their quality of life.

Major finding: Patients receiving PMDR had a reduction in perceived fatigue and improvement of walking abilities and health-related quality of life compared with control individuals. Improved performance on a motor sequence learning task in terms of accuracy was observed after rehabilitation. All improvements persisted at the 4-week follow-up. 

Study details: A longitudinal parallel group study included 24 patients with relapse-onset MS, who received a 4-week PMDR, and 24 control individuals. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Athina Papadopoulou, Laura Gaetano, Katrin Parmar, Thierry Ettlin, Corina Schuster-Amft, Jens Wuerfel, Ludwig Kappos, Till Sprenger, and Stefano Magon reported receiving research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Zuber P et al. J Neurol. 2020 Mar 2. doi: 10.1007/s00415-020-09768-6.

Key clinical point: Patients with moderate-to-severe multiple sclerosis (MS) contribute substantially to the disease-related morbidity burden.

Major finding: Patients in asymptomatic and mild stages of MS represent 68.4% of the population and contribute to 39.8% of the MS-specific morbidity. The remaining 60.2% of the MS-specific morbidity comes from the 31.6% of patients in the moderate or severe disease stages. 

Study details: The data come from an analysis of 1,412 patients with MS identified from the Swiss Multiple Sclerosis Registry. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Anke Salmen, Claudio Gobbi, Caroline Pot, Christian P. Kamm, Jens Kuhle, Pasquale Calabrese, Stefanie Müller, and Sven Schippling reported research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Kaufmann M et al. Front Neurol. 2020 Mar 6. doi: 10.3389/fneur.2020.00156.

Key clinical point: Patients with moderate-to-severe multiple sclerosis (MS) contribute substantially to the disease-related morbidity burden.

Major finding: Patients in asymptomatic and mild stages of MS represent 68.4% of the population and contribute to 39.8% of the MS-specific morbidity. The remaining 60.2% of the MS-specific morbidity comes from the 31.6% of patients in the moderate or severe disease stages. 

Study details: The data come from an analysis of 1,412 patients with MS identified from the Swiss Multiple Sclerosis Registry. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Anke Salmen, Claudio Gobbi, Caroline Pot, Christian P. Kamm, Jens Kuhle, Pasquale Calabrese, Stefanie Müller, and Sven Schippling reported research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Kaufmann M et al. Front Neurol. 2020 Mar 6. doi: 10.3389/fneur.2020.00156.

Key clinical point: Patients with moderate-to-severe multiple sclerosis (MS) contribute substantially to the disease-related morbidity burden.

Major finding: Patients in asymptomatic and mild stages of MS represent 68.4% of the population and contribute to 39.8% of the MS-specific morbidity. The remaining 60.2% of the MS-specific morbidity comes from the 31.6% of patients in the moderate or severe disease stages. 

Study details: The data come from an analysis of 1,412 patients with MS identified from the Swiss Multiple Sclerosis Registry. 

Disclosures: The study was supported by the Swiss Multiple Sclerosis Society. Anke Salmen, Claudio Gobbi, Caroline Pot, Christian P. Kamm, Jens Kuhle, Pasquale Calabrese, Stefanie Müller, and Sven Schippling reported research support/speaker fees/speaker honoraria/travel support/consultancy fees/advisory fees from one or more pharmaceutical companies and/or organizations. The remaining authors declared no conflict of interest.

Citation: Kaufmann M et al. Front Neurol. 2020 Mar 6. doi: 10.3389/fneur.2020.00156.