MS research update - 08 January 2010
- Timing of birth influences risk of developing MS
- Three year extension study shows fingolimod (FTY720) is safe and effective
- Review of cannabis research shows it improves spasticity in MS
Timing of birth influences risk of developing MS
The risk of developing MS is thought to be determined by a complex interplay between genetic and environmental factors. The present study sought to determine whether season of birth influences the likelihood of developing MS. The research was based on the data of 1,300 people with MS born within the West of Scotland between 1922 and 1992. A much higher than expected proportion was born in March, April or May, with April emerging as the peak month for births. In contrast, a lower proportion of births were seen in the autumn, particularly November.
Mothers of babies born in spring are pregnant during the darker months of the year and receive less exposure to sunlight. Exposure to sunlight is necessary for the body to manufacture vitamin D. One hypothesis that has been drawn is that this reduced exposure to sunlight during pregnancy could account for the increased risk of developing MS in individuals born in spring in Scotland.
Bayes HK, Weir CJ, O'Leary C.
Timing of birth and risk of multiple sclerosis in the Scottish population.
European Neurology 2009; 63(1)36-40.
Medline abstract
Three year extension study shows fingolimod (FTY720) is safe and effective
Fingolimod is an oral drug currently in development for the treatment of multiple sclerosis. Positive results emerged from a sixmonth placebo-controlled trial consisting of three groups of people with relapsing remitting MS: one group receiving a 1.25mg daily dose of fingolimod, a second group receiving a 5.0mg daily dose; and a third group receiving a daily placebo (inactive dummy drug). In the extension study all participants receiving the 1.25mg daily dose continued to do so, and participants receiving either the 5.0mg daily dose or placebo over the first six months were switched to receive the 1.25mg daily dose for the following 30 months.
At the end of the three years most participants showed significantly less disease activity on MRI and around 70% of participants who had received fingolimod from the start of the study remained relapse free. Over the three years, headache, fatigue and flu-like symptoms were among the most commonly reported side effects of treatment. The safety and effectiveness of fingolimod in relapsing remitting MS are being further investigated in a larger ongoing clinical trial.
Comi G, O'Connor P, Montalban X, et al.
Phase II study of oral fingolimod (FTY720) in multiple sclerosis: 3-year results.
Multiple Sclerosis 2009; [Epub ahead of print].
View abstract
Review of cannabis research shows it improves spasticity in MS
Research into the effectiveness of cannabis-based medicines in offering symptomatic relief to people with MS has produced some rather mixed results in recent years. The present paper reviewed the results of six research trials that assessed the effects of cannabis-based medicines on MS spasticity published between 2002 and 2007. The studies included a total of 481 people with MS who received a combination of the cannabis extracts delta-tetrahydrocannabinol (THC) and cannabidiol.
Five studies concluded that cannabis extract may decrease spasticity and improve mobility in people with MS. One study reported no reduction in spasticity. Adverse events were reported in all studies but the combined extracts were generally well tolerated.
The study authors highlight the fact that subjective improvements in spasticity (improvements based on participants' reports) were greater than improvements seen using objective (clinical) measures. Nevertheless, the review suggests that there is convincing evidence for the therapeutic role of cannabis-based medicines in MS and suggests further research is warranted.
Lakhan SE, Rowland M.
Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review.
BMC Neurol 2009;9:59.
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