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The 3 Most Important MS Breakthroughs, 2016 (AAN)

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  • The 3 Most Important MS Breakthroughs, 2016 (AAN)

    The American Academy of Neurology just made public its selection of the top three MS breakthroughs of 2016.- D

    Best Advances of 2016: Picks from the Neurology Today Editorial Advisory Board

    Every year, we ask members of our editorial advisory board — all leaders in their respective fields — to reflect on the most important advances, policies, and professional issues that occurred during the past 12 months. Here, in the "Best Advances of 2016," our editorial team sheds light on developments that were both incremental and transformational this past year. Read on to learn more about those advances — and why they are important — in such areas as ethics and professionalism, stroke, epilepsy, dementia, multiple sclerosis, neurogenetics, and peripheral neuropathy, to name a few. This year, too, we feature advances from some of the major neurology meetings held in 2016, including highlights of top-scored abstracts selected by the Science Committees.

    MULTIPLE SCLEROSIS

    John Corboy MD, FAAN, professor of neurology, University of Colorado School of Medicine, Aurora, CO.

    The Pick: Tourbah A, Lebrun-Frenay C, Edan G, et al, for the MS-SPI study group. MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: A randomised, double-blind, placebo-controlled study Mult Scler 2016;22(13):1719-1731.1.

    The Findings: In a double-blind, placebo-controlled trial, MD1003 (high-dose biotin) achieved sustained reversal of multiple sclerosis (MS)-related disability in a subset of patients with progressive MS, and it was well tolerated.
    Why It's Important: The study suggests the possibility of protecting neurons and oligodendrocytes from cell death in patients with progressive MS.

    The Picks: Several papers, among the top scored abstracts from the Science Committee of the Congress of the European Committee for Treatment and Research in MS, held in London in September. These studies have not yet been published in peer-reviewed journals.

    ECTRIMS Abstract P 1271: Piehl Fl, Kockum I, Khademi M, et al. High sensitivity measurement of neurofilament-light levels in plasma demonstrates a significant reduction in multiple sclerosis patients starting fingolimod.

    The Findings: Neurofilament is a neuronal protein that is released upon cell injury into the cerebrospinal fluid and into the blood of patients. Neurofilament-light levels indicate that there is ongoing activity in the brain. The average level of the neurofilament-light chain fell from 20.35 pg/ML to 13.75 pg/ML in MS patients after 12 months of fingolimod therapy, and continued to drop to a level of 13.23 pg/mL at 24 months.*

    Why It's Important: The possible development of a blood biomarker of neuronal damage, neurofilament-light levels, would have many uses, including assisting in diagnosis and in determining severity of illness, as well as defining response to medications.

    Read the Neurology Today article, "Neurofilament Blood Test Could Potentially Help Monitor MS Progression," at http://bit.ly/NT-neurofilament-MS.

    The Pick: ECTRIMS Abstract P751: Sormani MP, Schiavetti I, Signori A, et al. Autologous hematopoietic stem cell transplantation in multiple sclerosis: A meta-analysis.

    The Findings: In a pooled meta-analysis that included 15 clinical trials or series, about 67 percent of MS patients who underwent hematopoietic stem cell transplantation were estimated to have achieved a no-evidence-of-disease-activity state for at least five years.

    Why It's Important: This meta-analysis of high-dose immunoablation and stem cell rescue studies showed benefit, especially in younger patients with active disease. And this will, hopefully, lead to an international controlled clinical trial comparing this approach to other highly effective therapies.

    Read the Neurology Today article, "Meta-Analysis Shows Stem Cell Transplantation Halts MS Progression for At Least Five Years," at http://bit.ly/NT-stemcellMS.

    Dave Bexfield
    ActiveMSers
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