Developing New Symptomatic Therapies for MS
Drs. Rodriguez and Wingerchuk recently found that patients taking the equivalent of four regular aspirin tablets daily had reduced MS-related fatigue compared with those taking inactive placebo.
Now we are attempting to confirm the benefit of aspirin in a larger group of people and to determine if the benefit is related to its impact on inflammation. The team is recruiting 135 people with MS-related fatigue at the three Mayo campuses. Collaborators include Dr. Jonathan Carter (Scottsdale) and Dr. Elizabeth Shuster (Jacksonville)
Participants are completing questionnaires about the severity and impact of their fatigue, undergoing memory testing to assess cognitive fatigue, and are having blood taken to measure markers of inflammation. Some participants are also doing strength testing in a motor laboratory to assess motor fatigue. In addition, these studies will correlate cytokine and lymphokine levels in the blood with MS-related fatigue (funded by National Multiple Sclerosis Society NMSS RG 3806A1/1).
Multi-center Treatment Trials
MS specialists at Mayo Clinic are actively engaged in multi-center trials that explore innovative concepts to treat MS. Current studies directed by Dr. Mark Keegan include an NIH-funded study of combination treatment using both glatiramer acetate (Copaxone) and interferon (Avonex) determining whether using two drugs with differing mechanisms of action is more beneficial than a single drug (NINDS NS45719). Industry-sponsored studies include a phase III study of the promising novel monoclonal agent alemtuzumab in patients with relapsing remitting MS.
A recently funded clinical initiative is the Pediatric MS Center funded by the National MS Society (NMSS#1) and under the direction of Dr. Marc Patterson. The Pediatric Center for Excellence is investigating the potential environmental triggers for MS and other demyelinating disorders. Mayo is one of six Centers of Excellence participating in these endeavors. Clinical trials are underway with some of the drugs found effective in adult patients with MS.
Please refer to our earlier detailed discussion (Promoting Remyelination) of rHIgM22, the human monoclonal IgM that is proposed to promote remyelination in MS. The antibody will be used in a Phase I clinical trial first to demonstrate that it is not toxic and then in an effort to reverse neurologic deficit following an attack of multiple sclerosis that does not respond to conventional high dose methylprednisolone (supported by grants from the Hilton Foundation).