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Sclerosis Study Multiple

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05.06.2018

Content:

  • Sclerosis Study Multiple
  • Studies and Trials
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  • Without participants in research studies, MS research would come to a standstill. People with MS, and sometimes family members, can help advance MS. As of this writing, rodance.info -- the clinical trials registry created by the National Institutes of Health -- lists more than studies in multiple sclerosis which. Following is a list of surveys (mostly online) and other research studies seeking to recruit people with multiple sclerosis that has been reviewed by the Society.

    Sclerosis Study Multiple

    This allows them to look for proteins and inflammatory cells associated with the disease and to rule out other diseases that may look similar to MS, including some infections and other illnesses. MS is confirmed when positive signs of the disease are found in different parts of the nervous system at more than one time interval and there is no alternative diagnosis.

    The course of MS is different for each individual, which makes it difficult to predict. For most people, it starts with a first attack, usually but not always followed by a full to almost-full recovery. Weeks, months, or even years may pass before another attack occurs, followed again by a period of relief from symptoms. This characteristic pattern is called relapsing-remitting MS.

    Primary-progressive MS is characterized by a gradual physical decline with no noticeable remissions, although there may be temporary or minor relief from symptoms.

    This type of MS has a later onset, usually after age 40, and is just as common in men as in women. Secondary-progressive MS begins with a relapsing-remitting course, followed by a later primary-progressive course. The majority of individuals with severe relapsing-remitting MS will develop secondary progressive MS if they are untreated. Finally, there are some rare and unusual variants of MS. One of these is Marburg variant MS also called malignant MS , which causes a swift and relentless decline resulting in significant disability or even death shortly after disease onset.

    Determining the particular type of MS is important because the current disease modifying drugs have been proven beneficial only for the relapsing-remitting types of MS. An exacerbation—which is also called a relapse, flare-up, or attack—is a sudden worsening of MS symptoms, or the appearance of new symptoms that lasts for at least 24 hours. MS relapses are thought to be associated with the development of new areas of damage in the brain.

    Exacerbations are characteristic of relapsing-remitting MS, in which attacks are followed by periods of complete or partial recovery with no apparent worsening of symptoms.

    An attack may be mild or its symptoms may be severe enough to significantly interfere with life's daily activities. Most exacerbations last from several days to several weeks, although some have been known to last for months. When the symptoms of the attack subside, an individual with MS is said to be in remission. However, MRI data have shown that this is somewhat misleading because MS lesions continue to appear during these remission periods.

    Patients do not experience symptoms during remission because the inflammation may not be severe or it may occur in areas of the brain that do not produce obvious symptoms. Research suggests that only about 1 out of every 10 MS lesions is perceived by a person with MS. Therefore, MRI examination plays a very important role in establishing an MS diagnosis, deciding when the disease should be treated, and determining whether treatments work effectively or not.

    It also has been a valuable tool to test whether an experimental new therapy is effective at reducing exacerbations. There is still no cure for MS, but there are treatments for initial attacks, medications and therapies to improve symptoms, and recently developed drugs to slow the worsening of the disease.

    These new drugs have been shown to reduce the number and severity of relapses and to delay the long term progression of MS. The usual treatment for an initial MS attack is to inject high doses of a steroid drug, such as methylprednisolone, intravenously into a vein over the course of 3 to 5 days.

    It may sometimes be followed by a tapered dose of oral steroids. Intravenous steroids quickly and potently suppress the immune system, and reduce inflammation. Clinical trials have shown that these drugs hasten recovery. The rest of the blood, plus replacement plasma, is then transfused back into the body.

    This treatment has not been shown to be effective for secondary progressive or chronic progressive forms of MS. During the past 20 years, researchers have made major breakthroughs in MS treatment due to new knowledge about the immune system and the ability to use MRI to monitor MS in patients.

    As a result, a number of medical therapies have been found to reduce relapses in persons with relapsing-remitting MS. These drugs are called disease modulating drugs. There is debate among doctors about whether to start disease modulating drugs at the first signs of MS or to wait until the course of the disease is better defined before beginning treatment.

    On one hand, U. Food and Drug Administration FDA -approved medications to treat MS work best early in the course of the disease and work poorly, if at all, later in the progressive phase of the illness. Clinical trials have shown convincingly that delaying treatment, even for the 1 to-2 years that it may take for patients with MS to develop a second clinical attack, may lead to an irreversible increase in disability.

    In addition, people who begin treatment after their first attack have fewer brain lesions and fewer relapses over time. On the other hand, initiating treatment in patients with a single attack and no signs of previous MS lesions, before MS is diagnosed, poses risks because all FDA-approved medications to treat MS are associated with some side effects. Therefore, the best strategy is to have a thorough diagnostic work-up at the time of first attack of MS.

    The work-up should exclude all other diseases that can mimic MS so that the diagnosis can be determined with a high probability. The diagnostic tests may include an evaluation of the cerebrospinal fluid and repeated MRI examinations. If such a thorough work-up cannot confirm the diagnosis of MS with certainty, it may be prudent to wait before starting treatment. However, each patient should have a scheduled follow-up evaluation by his or her neurologist 6 to 12 months after the initial diagnostic evaluation, even in the absence of any new attacks of the disease.

    Ideally, this evaluation should include an MRI examination to see if any new MS lesions have developed without causing symptoms. This group makes up 10 to 20 percent of those with MS. Doctors were concerned about exposing such benign MS patients to the side effects of MS drugs. However, recent data from the long-term follow-up of these patients indicate that after 10 to 20 years, some of these patients become disabled. Therefore, current evidence supports discussing the start of therapy early with all people who have MS, as long as the MS diagnosis has been thoroughly investigated and confirmed.

    There is an additional small group of individuals approximately 1 percent whose course will progress so rapidly that they will require aggressive and perhaps even experimental treatment. The current FDA-approved therapies for MS are designed to modulate or suppress the inflammatory reactions of the disease.

    They are most effective for relapsing-remitting MS at early stages of the disease. These treatments include injectable beta interferon drugs. Interferons are signaling molecules that regulate immune cells. Potential side effects of beta interferon drugs include flu-like symptoms, such as fever, chills, muscle aches, and fatigue, which usually fade with continued therapy.

    A few individuals will notice a decrease in the effectiveness of the drugs after 18 to 24 months of treatment due to the development of antibodies that neutralize the drugs' effectiveness.

    If the person has flare-ups or worsening symptoms, doctors may switch treatment to alternative drugs. Glatiramer acetate is another injectable immune-modulating drug used for MS. Exactly how it works is not entirely clear, but research has shown that it changes the balance of immune cells in the body. Side effects with glatiramer acetate are usually mild, but it can cause skin reactions and allergic reactions. It is approved only for relapsing forms of MS.

    The drug mitoxantrone, which is administered intravenously four times a year, has been approved for especially severe forms of relapsing-remitting and secondary progressive MS.

    This drug has been associated with development of certain types of blood cancers in up to one percent of patients, as well as with heart damage. Therefore, this drug should be used as a last resort to treat patients with a form of MS that leads to rapid loss of function and for whom other treatments did not stop the disease.

    Natalizumab works by preventing cells of the immune system from entering the brain and spinal cord. It is administered intravenously once a month.

    It is a very effective drug for many people, but it is associated with an increased risk of a potentially fatal viral infection of the brain called progressive multifocal encephalopathy PML. People who take natalizumab must be carefully monitored for symptoms of PML, which include changes in vision, speech, and balance that do not remit like an MS attack.

    Therefore, natalizumab is generally recommended only for individuals who have not responded well to the other approved MS therapies or who are unable to tolerate them. Other side effects of natalizumab treatment include allergic and hypersensitivity reactions. The drug prevents white blood cells called lymphocytes from leaving the lymph nodes and entering the blood and the brain and spinal cord. The decreased number of lymphocytes in the blood can make people taking fingolimod more susceptible to infections.

    The drug may also cause problems with eyes and with blood pressure and heart rate. The exact frequency of rare side effects such as severe infections of fingolimod is unknown. In March , the FDA approved ocrelizumab brand name Ocrevus to treat adults with relapsing forms of MS and promary progressive multiple sclerosis. Other FDA-approved drugs to treat relapsing forms of MS in adults include dimethyl fumarate and teriflunomide, both taken orally.

    MS causes a variety of symptoms that can interfere with daily activities but which can usually be treated or managed to reduce their impact. Many of these issues are best treated by neurologists who have advanced training in the treatment of MS and who can prescribe specific medications to treat the problems. Eye and vision problems are common in people with MS but rarely result in permanent blindness.

    Inflammation of the optic nerve or damage to the myelin that covers the optic nerve and other nerve fibers can cause a number of symptoms, including blurring or graying of vision, blindness in one eye, loss of normal color vision, depth perception, or a dark spot in the center of the visual field scotoma. Uncontrolled horizontal or vertical eye movements nystagmus and "jumping vision" opsoclonus are common to MS, and can be either mild or severe enough to impair vision.

    Double vision diplopia occurs when the two eyes are not perfectly aligned. This occurs commonly in MS when a pair of muscles that control a specific eye movement aren't coordinated due to weakness in one or both muscles.

    Double vision may increase with fatigue or as the result of spending too much time reading or on the computer. Periodically resting the eyes may be helpful. Spasticity refers to muscles that are stiff or that go into spasms without any warning. Spasticity in MS can be as mild as a feeling of tightness in the muscles or so severe that it causes painful, uncontrolled spasms.

    It can also cause pain or tightness in and around the joints. People with MS sometimes develop tremor, or uncontrollable shaking, often triggered by movement. Tremor can be very disabling. Assistive devices and weights attached to limbs are sometimes helpful for people with tremor. Many people with MS experience difficulty walking. In fact, studies indicate that half of those with relapsing-remitting MS will need some kind of help walking within 15 years of their diagnosis if they remain untreated.

    People with severe ataxia generally benefit from the use of a cane, walker, or other assistive device. Physical therapy can also reduce walking problems in many cases.

    It is the first drug approved for this use. Clinical trials showed that patients treated with dalfampridine had faster walking speeds than those treated with a placebo pill. Fatigue is a common symptom of MS and may be both physical for example, tiredness in the legs and psychological due to depression.

    Probably the most important measures people with MS can take to counter physical fatigue are to avoid excessive activity and to stay out of the heat, which often aggravates MS symptoms.

    On the other hand, daily physical activity programs of mild to moderate intensity can significantly reduce fatigue. An antidepressant such as fluoxetine may be prescribed if the fatigue is caused by depression.

    Other drugs that may reduce fatigue in some individuals include amantadine and modafinil. Some people benefit from stress management programs, relaxation training, membership in an MS support group, or individual psychotherapy. Treating sleep problems and MS symptoms that interfere with sleep such as spastic muscles may also help. Trigeminal neuralgia is a sharp, stabbing, facial pain caused by MS affecting the trigeminal nerve as it exits the brainstem on its way to the jaw and cheek.

    It can be treated with anticonvulsant or antispasmodic drugs, alcohol injections, or surgery. Drugs such as gabapentin and nortryptiline sometimes help to reduce central pain. Burning, tingling, and prickling commonly called "pins and needles" are sensations that happen in the absence of any stimulation. Chronic back or other musculoskeletal pain may be caused by walking problems or by using assistive aids incorrectly.

    Treatments may include heat, massage, ultrasound treatments, and physical therapy to correct faulty posture and strengthen and stretch muscles. The most common bladder control problems encountered by people with MS are urinary frequency, urgency, or the loss of bladder control. The same spasticity that causes spasms in legs can also affect the bladder. A small number of individuals will have the opposite problem—retaining large amounts of urine. Urologists can help with treatment of bladder-related problems.

    A number of medical treatments are available. Constipation is also common and can be treated with a high-fiber diet, laxatives, and other measures. People with MS sometimes experience sexual problems. Sexual arousal begins in the central nervous system, as the brain sends messages to the sex organs along nerves running through the spinal cord. If MS damages these nerve pathways, sexual response—including arousal and orgasm—can be directly affected.

    Sexual problems may also stem from MS symptoms such as fatigue, cramped or spastic muscles, and psychological factors related to lowered self-esteem or depression. Some of these problems can be corrected with medications. Psychological counseling also may be helpful. Studies indicate that clinical depression is more frequent among people with MS than it is in the general population or in persons with many other chronic, disabling conditions. MS may cause depression as part of the disease process, since it damages myelin and nerve fibers inside the brain.

    If the plaques are in parts of the brain that are involved in emotional expression and control, a variety of behavioral changes can result, including depression. Depression can intensify symptoms of fatigue, pain, and sexual dysfunction. It is most often treated with selective serotonin reuptake inhibitor SSRI antidepressant medications, which are less likely than other antidepressant medications to cause fatigue. MS is sometimes associated with a condition called pseudobulbar affect that causes inappropriate and involuntary expressions of laughter, crying, or anger.

    These expressions are often unrelated to mood; for example, the person may cry when they are actually very happy, or laugh when they are not especially happy. In the FDA approved the first treatment specifically for pseudobulbar affect, a combination of the drugs dextromethorphan and quinidine. The condition can also be treated with other drugs such as amitriptyline or citalopram. Half -to three-quarters of people with MS experience cognitive impairment, which is a phrase doctors use to describe a decline in the ability to think quickly and clearly and to remember easily.

    These cognitive changes may appear at the same time as the physical symptoms or they may develop gradually over time. Some individuals with MS may feel as if they are thinking more slowly, are easily distracted, have trouble remembering, or are losing their way with words. The right word may often seem to be on the tip of their tongue. Some experts believe that it is more likely to be cognitive decline, rather than physical impairment, that causes people with MS to eventually withdraw from the workforce.

    A number of neuropsychological tests have been developed to evaluate the cognitive status of individuals with MS. Based on the outcomes of these tests, a neuropsychologist can determine the extent of strengths and weaknesses in different cognitive areas.

    Many people with MS use some form of complementary or alternative medicine. These therapies come from many disciplines, cultures, and traditions and encompass techniques as different as acupuncture, aromatherapy, ayurvedic medicine, touch and energy therapies, physical movement disciplines such as yoga and tai chi, herbal supplements, and biofeedback. Because of the risk of interactions between alternative and more conventional therapies, people with MS should discuss all the therapies they are using with their doctor, especially herbal supplements.

    Although herbal supplements are considered "natural," they have biologically-active ingredients that could have harmful effects on their own or interact harmfully with other medications. Although researchers haven't been able to identify the cause of MS with any certainty, there has been excellent progress in other areas of MS research—especially in development of new treatments to prevent exacerbations of the disease.

    New discoveries are constantly changing treatment options for patients. Some researchers are investigating promising avenues for therapeutics, such as drugs that would protect myelin cells from damage or that could help them recover after an attack.

    Interfering with the inflammatory cells and substances involved in the development of MS lesions or keeping immune-system cells from crossing the blood-brain barrier could potentially thwart an attack. There are many new treatments that have been shown to prevent the formation of new MS lesions in small studies. These include injectable drugs called rituximab, ocrelizumab, daclizumab, and alemtuzumab and oral drugs such as cladribine, laquinimod, teriflunamide, and fumaric acid.

    NINDS is also sponsoring a clinical trial to determine whether combining two therapies, glatiramer acetate and beta-interferon, is beneficial for preventing relapses. This treatment appears to re-set the immune system so that it no longer attacks the brain. This strategy is being tested in clinical trials. Other studies are investigating whether transplanting stem cells derived from bone marrow, called mesenchymal stem cells, may be helpful in MS.

    A study suggested that a condition called chronic cerebrospinal venous insufficiency CCSVI , which results from inadequate blood flow in veins leading from the brain, may contribute to the symptoms of MS. The suggested treatment called for reopening the veins that lead to the central nervous system.

    However, study results by the same investigators, released in , show the treatment to be ineffective. The proposed study utilizes a prospective, non-interventional, observational cohort study design to evaluate the necessary duration of monitoring following treatment with LEMTRADA and to further inform appropriate monitoring conditions.

    The purpose of this study is to measure safe and tolerable doses of rHIgM22 in patients with MS immediately following a relapse. The purpose of this study is to characterize the full pharmacokinetic and pharmacodynamics profiles of RPC in patients with relapsing multiple sclerosis RMS. Multiple sclerosis MS is a chronic and often disabling disorder of the central nervous system involving damage to the brain, optic nerves and spinal cord.

    Most patients initially present with relapsing remitting MS, experiencing unpredictable episodes of transient neurological deterioration relapse followed by a variable period of recovery remission during The primary objective of this study is to evaluate whether montelukast can reduce the severity of GI events after oral administration of DMF in subjects with relapsing forms of MS.

    Search Medical Condition Please enter condition. Please choose location from dropdown. Study Type Interventional Trial Phase Phase 1 Multiple Sclerosis Clinical Trials A listing of Multiple Sclerosis medical research trials actively recruiting patient volunteers.

    Studies and Trials

    Top 10 Multiple Sclerosis Studies of SPT Staff. Publish Date: Monday, December 24, From clinical trials evaluating treatments to studies unearthing. 17, — A new study finds multiple sclerosis treatments have long-term benefits, and that early treatment is important. The study is the first to provide. Jul 6, Hope Through Research: Multiple Sclerosis brochure cover . Studies of families indicate that relatives of an individual with MS have an.

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    aqpoh9i

    Top 10 Multiple Sclerosis Studies of SPT Staff. Publish Date: Monday, December 24, From clinical trials evaluating treatments to studies unearthing.

    shadowofpain

    17, — A new study finds multiple sclerosis treatments have long-term benefits, and that early treatment is important. The study is the first to provide.

    LaFaNyA

    Jul 6, Hope Through Research: Multiple Sclerosis brochure cover . Studies of families indicate that relatives of an individual with MS have an.

    mistykrus

    Aug 29, Results from a clinical trial of more than participants with progressive multiple sclerosis (MS) revealed that ibudilast was better than a.

    indiscreet8

    Multiple Sclerosis Clinical Research Trial Listings in Musculoskeletal Search for closest city to find more detailed information on a research study in your area.

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