Prospective Investigation of Multiple Sclerosis in the Three Rivers Region

Prospective Investigation of Multiple Sclerosis in the Three Rivers Region The PROMOTE Research Project aims to understand individual variation and realize precision medicine No other chronic disease
5.

The goal of this long-term, prospective, observational research study is to understand what makes individuals with multiple sclerosis (MS) and related disorders differ from one another. Specifically, we aim to investigate the predictors of the individual differences in disease trajectory and treatment response using a wide range of biological, biometric, imaging, environmental, and clinical measurements. Understanding the factors that influence disease trajectory and treatment response will pave the way to realize precision medicine and deliver individualized care. Eligibility of Patient Participants:
1. 7 years and older
2. Willing and able to provide consent (for >=18 years) or assent with permission from at least one of the child's parents (for

Our recent study examining the cost of treatments just got published.https://link.springer.com/article/10.1007/s40120-...
05/23/2022

Our recent study examining the cost of treatments just got published.
https://link.springer.com/article/10.1007/s40120-022-00358-4

https://twitter.com/Neurology_Ther/status/1528768357826285569

Introduction Comparisons of healthcare utilization and expenditure among multiple sclerosis (MS) disease-modifying therapies (DMTs) are limited. Methods In this retrospective cohort study using commercial insurance claims data of a US population (2010–2019), we compared healthcare utilization and ...

In this observational cohort study of 1621 secondary progressive multiple sclerosis (SPMS) patients, researchers examine...
05/02/2021

In this observational cohort study of 1621 secondary progressive multiple sclerosis (SPMS) patients, researchers examined the association of relapse activity and immune disease-modifying treatments (DMT) with the rate of disability accumulation and wheelchair dependency. Higher relapse rate during the SPMS phase was associated with faster rate of disability accumulation. DMT for patients experiencing relapse during SPMS slowed the rate of disability accumulation and wheelchair dependency.

The concept of "active" SPMS is misleading, as it probably represents just the late stage of relapsing MS. Thus, it is not surprising that DMT for relapsing MS, including the late stage, reduces disability accumulation.

This cohort study uses data from the MSBase international registry to examine the association of demographic and clinical factors, including the presence of relapses and exposure to immunotherapy, with the rate of disability accumulation in patients with secondary progressive multiple sclerosis.

The National Multiple Sclerosis Society is dedicated to creating a world free of MS, but they can't do it without our he...
04/22/2021

The National Multiple Sclerosis Society is dedicated to creating a world free of MS, but they can't do it without our help. It’s faster and easier than ever to support this cause. Your donation will drive groundbreaking research, provide life-changing services and guarantee a supportive community for those who need it most. Please visit Team: UPMC MS CHAMPIONS fundraising page to join our team or make a donation. By joining our team, you will be signing up for a great event and an important cause. Each mile we walk, each dollar we raise brings us that much closer to our goal – an end to MS.

Together, we will end MS. Simply click the link below to visit our page and make a donation.

Walk MS connects people living with MS and those who care about them.

Sphingosine-1-phosphate receptor (S1P1R) is a promising target for immunomodulation in MS. The first S1P1R modulator, Fi...
04/19/2021

Sphingosine-1-phosphate receptor (S1P1R) is a promising target for immunomodulation in MS. The first S1P1R modulator, Fingolimod, received approval in 2010 for treatment of relapsing type of multiple sclerosis (MS). To address the side effect profile of fingolimod, there has been development of several selective S1P1R receptor modulators. Ponesimod is an oral selective S1P1R modulator that induces a rapid, dose-dependent, and reversible sequestration of lymphocytes in lymphoid organs. This phase 3 multicenter, double-blind randomized clinical trial compared ponesimod (20mg daily, n=567) to teriflunomide (14mg daily n=566), a pyrimidine synthesis inhibitor previously approved for relapsing MS. Randomization was stratified by use of MS disease modifying therapy in the 2 years prior (presence or absence) and baseline Expanded Disability Status Scale score (≤3.5 or >3.5). Ponesimod reduced the annualized relapse rate (30.5%), brain volume loss (0.34%), focal active inflammatory disease activity (56%) and fatigue (mean difference -3.57 on Fatigue Symptom and Impact Questionnaire–Relapsing Multiple Sclerosis), while the proportion of patients achieving the status of no evidence of disease activity was greater for ponesimod (25% v. 16%). There was no difference in time to confirmed disability accumulation. The side effect profile of ponesimod is similar to other S1P1-R modulators. While adverse events were similar between the two groups, treatment discontinuation was greater for ponesimod. The results from this study supports the efficacy superiority of ponesimod over teriflunomide in individuals with MS.

This superiority study compares the efficacy of ponesimod, a selective sphingosine-1-phosphate receptor 1 modulator with teriflunomide, a pyrimidine synthesis inhibitor, approved for the treatment of patients with relapsing multiple sclerosis.

Cognitive impairment is common in multiple sclerosis (MS) and the spectrum of manifestation is heterogeneous across peop...
04/10/2021

Cognitive impairment is common in multiple sclerosis (MS) and the spectrum of manifestation is heterogeneous across people with MS (pwMS). Using a data-driven approach (latent profile analysis), this cross-sectional study of 1212 pwMS and 196 healthy control individuals uncovered 5 distinct cognitive phenotypes (preserved cognition, mild–verbal memory/semantic fluency, mild–multidomain, severe–executive/attention, and severe–multidomain) that differ significantly across clinical, demographic and neuroimaging features. Importantly, severe cognitive phenotypes are associated with disease duration and progressive disease stages. Given that the current, dichotomous classification fails to adequately account for heterogeneity in cognitive function, the more granular cognitive phenotypes could better define neurological disability in MS and guide cognitive rehabilitation.

This cross-sectional study presents a data-driven classification of cognitive functions in patients with multiple sclerosis.

In a cross-sectional analysis of ~1,600 people with multiple sclerosis (PwMS) with laboratory-confirmed or highly suspec...
03/25/2021

In a cross-sectional analysis of ~1,600 people with multiple sclerosis (PwMS) with laboratory-confirmed or highly suspected COVID-19 from a North American physician-reported registry, non-ambulatory status was associated with clinical severity (hospital admission, critical care / ventilator need, or death). Older age was associated with increased hospital admission and death) while African-American race was associated with increased hospital admission). Other risk factors included cardiovascular comorbidities (diabetes, hypertension, morbid obesity), and recent treatment with corticosteroids. Both rituximab and ocrelizumab were associated with hospital admissions, and neither was associated with critical care / ventilator need or death. The findings are consistent with prior reports.

Data in the CoViMS registry are based on voluntary physician reports, which likely bias towards over-reporting of severe COVID-19 cases and under-reporting of mild or asymptomatic cases, which represent the majority of the COVID-19 cases in the general population and among PwMS. Further, the findings did not account for socioeconomic status, which is notable confounder. Efforts such as our own MSReCOV study that use patient-reported data to capture the experience of the majority of PwMS, including mild and even asymptomatic COVID-19, complement the physician-reported efforts.

This cross-sectional study examines outcomes and risk factors associated with COVID-19 clinical severity in a large, diverse cohort of North American patients with multiple sclerosis.

To investigate the association of immune disease-modifying therapy and long-term disability in relapsing type of multipl...
03/18/2021

To investigate the association of immune disease-modifying therapy and long-term disability in relapsing type of multiple sclerosis (MS), the researchers used treatment and outcome data from an international registry. Among the 1,085 patients with at least 15 years of follow-up data, the continually treated patients were less likely to experience relapses, disability accrual or requirement for gait assistance, when compared to patients without continued treatment. Notably, the vast majority of the continually treated patients in this study received standard-efficacy first line agents such as interferon-beta or glatiramer acetate. Further, aging can further contribute to the association. The study provides class IV evidence that long-term exposure to disease-modifying therapy is associated with lower neurological disability.

Objective To test the hypothesis that immunotherapy prevents long-term disability in relapsing-remitting multiple sclerosis (MS), we modeled disability outcomes in 14,717 patients. Methods We studied patients from MSBase followed for ≥1 year, with ≥3 visits, ≥1 visit per year, and exposed to M...

Amantadine, modafinil, and methylphenidate are three of the most commonly prescribed symptomatic treatments for fatigue ...
03/08/2021

Amantadine, modafinil, and methylphenidate are three of the most commonly prescribed symptomatic treatments for fatigue for people with multiple sclerosis (MS), but robust evidence to support the use of these medications for this indication has been lacking. In this randomized, crossover, four-sequence, and double-blind clinical trial, researchers compared the efficacy of these three drugs to placebo. The intention-to-treat analysis was based on the improvement in the patient-reported outcome of fatigue (MFIS, modified fatigue impact scale scores). Amantadine, modafinil, and methylphenidate were not superior to placebo in improving multiple sclerosis fatigue and caused more frequent adverse events. There was a significant improvement in MFIS scores among participants on the placebo, suggesting a potential placebo effect. The results of this study do not support an indiscriminate use of amantadine, modafinil, or methylphenidate for the treatment of fatigue in multiple sclerosis.

Amantadine, modafinil, and methylphenidate were not superior to placebo in improving multiple sclerosis fatigue and caused more frequent adverse events. The results of this study do not support an indiscriminate use of amantadine, modafinil, or methylphenidate for the treatment of fatigue in multipl...

To address the need to better guide treatment selection in multiple sclerosis (MS), we leveraged electronic health recor...
02/24/2021

To address the need to better guide treatment selection in multiple sclerosis (MS), we leveraged electronic health records (EHR) data readily available at the point care and machine learning to develop a clinically deployable tool for predicting the risk of inflammatory disease activity (or relapse) in MS. The final model, comprising age, disease duration and prior 1-year relapse history imputed from EHR data, achieved accuracy comparable to other clinical prediction tools and outperformed baseline models. Importantly, the final model does not require knowledge of a patient's prior relapse frequency, which is a key predictor often unavailable at the point of care. Finally, this novel model produces a clinically meaningful estimate of a patient's relapse risk over the course of this chronic disease.

Objective No relapse risk prediction tool is currently available to guide treatment selection for multiple sclerosis (MS). Leveraging electronic health record (EHR) data readily available at the poi...

We would like to invite participants with and without a diagnosis of multiple sclerosis (MS) for an online survey study ...
02/23/2021

We would like to invite participants with and without a diagnosis of multiple sclerosis (MS) for an online survey study to help understand the current feelings about receiving (or not receiving) the COVID-19 vaccine and to evaluate the tolerability and safety for those who receive vaccination. Participation involves completing a few online surveys over 1 year. Your participation will help us gather important real-world evidence of COVID-19 vaccination in people with MS.

Any adult age 18 or above could participate. There is no geographic restriction.

We are specifically looking to reach controls (healthy or other disease) from the community AND patients with MS and related disorders who are not already enrolled in the PROMOTE cohort study.

Potential participants could directly use the following link to the institution-approved HIPAA-compliant survey platform:
https://redcap.link/covid19_vaccine_ms

If there is any question, please contact us at

As part of our ongoing effort to understand the impact that the COVID19 outbreak has had on our patients, we would like to ask you some focused questions regarding the recent introduction of the COVID-19 vaccine. We therefore ask that you please complete the following short survey addressing this to...

To examine the risk and impact of COVID-19 among persons with neuroinflammatory disorders (NID), we launched the Multipl...
02/23/2021

To examine the risk and impact of COVID-19 among persons with neuroinflammatory disorders (NID), we launched the Multiple Sclerosis Resilience to COVID-19 (MSReCOV) Collaborative project. In this first publication, we reported the experience of 1115 participants (630 with NID, 98% with multiple sclerosis; 485 controls) who completed an online survey study in April 2020 during the first peak of the COVID-19 pandemic. People with NID had the same proportion of suspected or confirmed COVID-19 as controls. The risk of COVID-19 increased with greater neurological disability in people with NID. IFN-beta treatment was associated with a lower prevalence of COVID-19 symptoms. Our study of real-time, patient-reported experience during the COVID-19 pandemic complements physician-reported MS case registries which capture an excess of severe cases.

Objective To report initial results of a planned multicenter year‐long prospective study examining the risk and impact of COVID‐19 among persons with neuroinflammatory disorders (NID), particularly ...

Address

Pittsburgh, PA
15260

Opening Hours

8am - 5pm

Telephone

+14122544883

Website

Alerts

Be the first to know and let us send you an email when Prospective Investigation of Multiple Sclerosis in the Three Rivers Region posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to Prospective Investigation of Multiple Sclerosis in the Three Rivers Region:

Shortcuts

Share

Share on Facebook Share on Twitter Share on LinkedIn
Share on Pinterest Share on Reddit Share via Email
Share on WhatsApp Share on Instagram Share on Telegram

Category