MS advances reported at AAN meeting. (news).

This year, results of 197 MS-related research projects were presented at the annual meeting of the American Academy of Neurology (AAN). Among the highlights:

* Dr. Claudia Lucchinetti (Rochester, MN) gave an update on the National MS Society--funded MS Lesion Project. This five-year project is an international collaboration to study lesions (damaged areas in the brain). Dr. Lucchinetti had found four distinct types of lesions that differ among individuals. New findings indicate that these different patterns of tissue damage may respond to different kinds of treatment.

* Dr. Fred Lublin (New York, NY) and his colleagues extended an earlier study in which 33 people with relapsing-remitting MS using Avonex (interferon beta-1a) were also given Copaxone (glatiramer acetate). The results hint at a possible benefit of combined therapy. A larger study is planned.

* Dr. Catherine Dalton (London, UK) and her colleagues followed 213 people who had been enrolled in a six-month study of an antibody called Antegren (natalizumab) vs. inert placebo injection, for an additional six months after the experimental treatment stopped. There were no significant differences in the number of relapses or new lesions between the two groups once treatment stopped, suggesting that use of Antegren must be continued for its benefits to be sustained.

* Dr. Kenneth Johnson (Baltimore, MD) and his colleagues have now followed 142 people taking Copaxone for relapsing-remitting MS for eight years. Their relapse rate has fallen from 1.49 every five years to 1 every five years. Those who took a placebo for the first 30 months of this study and then crossed over to active treatment have not done as well as those who have used Copaxone for the full eight years.

Several studies were presented on Novantrone (mitoxantrone), for worsening forms of MS:

* Dr. Emanuelle LePage (Rennes, France) evaluated 100 people who took Novantrone plus methylprednisolone for worsening relapsing-remitting MS before taking other disease-modifying therapies. Relapse rate and disease activity on MRI were reduced significantly.

* Dr. Gilles Edan (Rennes, France) followed 802 people with MS taking Novantrone and found they generally tolerated it well. The drug was given at less than the maximum total dose to avoid potential heart damage. Two people developed acute myelogenous leukemia, a higher than normal incidence of this type of cancer.

* Dr. Douglas Jeffery (Winston-Salem, NC) and his colleagues treated 10 people with worsening relapsing-remitting or secondary-progressive MS with a combination of Novantrone and Betaseron. Their relapse rates decreased by 74%.

* Dr. Daniel Mikol (Ann Arbor, MI) tested Novantrone and Zinecard (dexrazoxane, a cardioprotective agent) in 26 people, and reported that the combination is safe. He is continuing to study this to determine if the combination will decrease the risk of heart damage associated with Novantrone.

In other research:

* Dr. Eva Havrdova (Prague, Czech Republic) studied Avonex with azathioprine (an immunosuppressive agent) and low-dose steroids in 105 people with relapsing-remitting MS, and found that the combination reduced the relapse rate by 56% the first year and 72% the second year.

* Dr. Christopher Kenney (La Jolla, CA) showed that ginkgo biloba was well tolerated by 23 people with mild MS, and possibly had a beneficial effect on attention, memory, and fatigue.

* Dr. James Miller (New York, NY) and colleagues studied Viagra (sildenafil citrate) vs. placebo in 206 men with erectile dysfunction and MS. Treatment was effective.

* Dr. Dean Wingerchuk (Scottsdale, AZ) found that 13 out of 30 people with MS reported good or excellent improvement in fatigue levels when they took aspirin, compared with three of the same group who felt better when they took a placebo.

The results of many laboratory studies related to MS were also reported at the meeting as more and more scientists work on answers to the complex mysteries of multiple sclerosis.