Prospective Investigation of Multiple Sclerosis in the Three Rivers Region

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 CO...VID-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

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. https://jamanetwork.com//jamaneu/article-abstract/2768700

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. https://secure.nationalmssociety.org/site/TR

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 lymphoi...d 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 QuestionnaireRelapsing 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. https://jamanetwork.com//jamaneurology/fullarticle/2777917

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, mildverbal memory/semantic fluency, mildmultidomain, severeexecutive/attention, and severemultidomain) that differ significantly across clin...ical, 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. https://jamanetwork.com//jamaneur/article-abstract/2774172

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 inc...luded 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. https://jamanetwork.com/j/jamaneurology/fullarticle/2777735