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Spring 2010
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New Treatments Offered for Multiple Sclerosis


VS-Spring2010-MultipleSclerosis-Woman-in-WheelchairWhile multiple sclerosis (MS) remains incurable, unpredictable and often progressive, new therapies are increasingly enabling physicians to both control the disease and help patients function better.

“State-of-the-art treatment demands a combination of disease-modifying therapy and symptom management, along with the expertise of a multidisciplinary team of professionals — physical and occupational therapists, speech therapists, psychologists and other healthcare professionals,” says Barbara Giesser, M.D., a neurologist with the UCLA Multiple Sclerosis Research and Treatment Program and medical director of theUCLA Marilyn Hilton Achievement Center. “A comprehensive approach can make a major impact in improving the patient’s life.”

MS is an autoimmune disease of the central nervous system that is characterized by an attack on myelin, the tissue that protects the brain’s nerve fibers. This interferes with the nerves’ ability to send signals to and from the brain and can result in symptoms such as difficulty with balance and memory.

Although current medications are much enhanced, helping to improve symptomatic treatments and preventing new nerve damage, there are limitations: they involve daily, weekly or monthly self-injections; they don’t work for everyone; and they don’t completely shut down the disease. But a new generation of MS therapies appears imminent — drugs that offer the advantage of improving symptoms as well as drugs that are better at limiting nerve damage.

Moreover, many of the medications currently under review by the Food and Drug Administration can be taken orally. “The first thing patients always ask me is, ‘When can I stop doing these injections?’” says Nancy Sicotte, M.D., a neurologist with the UCLA Multiple Sclerosis Research and Treatment Program.

One experimental drug that is cause for great optimism represents a departure from standard anti-inflammatory MS treatments. The oral drug, which is being studied at UCLA and 15 other sites, uses the female hormone estriol and is based on research first conducted at UCLA by Rhonda Voskuhl, M.D., director of the UCLA Multiple Sclerosis Research and Treatment Program and head of the current clinical trial.

VS-Spring2010-MultipleSclerosis-DrConsultIt had long been observed that pregnant women with MS experienced a sharp drop in relapses. Dr. Voskuhl found that the reason was a protective effect from the increase of estriol during pregnancy. Dr. Sicotte is using sophisticated imaging techniques to track the impact of this hormone treatment in the ongoing clinical trial of estriol. She hopes to demonstrate that the drug has not only the anti-inflammatory effects of standard MS medications, but also serves to protect the nerves so that the brain suffers less damage in case of an attack. The drug also has a long record of safety — estriol has been in widespread use in Europe and Asia as hormone therapy for women with menopausal symptoms.

“This is a very exciting time,” Dr. Giesser says. “Research is helping to identify new and promising therapies to treat symptoms and improve function, as well as control the disease process itself.”

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