20th Meeting of the European Neurological Society, 19-23 June 2010, Berlin, Germany.
Article Type: Conference notes
Subject: Neurology (Conferences, meetings and seminars)
Multiple sclerosis (Research)
Author: Milonas, Ioannis
Pub Date: 11/01/2010
Publication: Name: The International MS Journal Publisher: PAREXEL MMS Europe Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 PAREXEL MMS Europe Ltd. ISSN: 1352-8963
Issue: Date: Nov, 2010 Source Volume: 17 Source Issue: 3
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Germany Geographic Code: 4EUGE Germany
Accession Number: 256365669
Full Text: More than 3000 neurologists attended the 20th Meeting of the European Neurological Society (ENS) and participated in the exciting and highly scientific programme. Eighty per cent of the submitted abstracts, which covered all aspects of neurology, were accepted. One major symposium, 16 oral presentations and 112 posters on multiple sclerosis (MS) were included in the programme. Additionally, there were three teaching courses and one interactive case presentation on MS.

In the New Treatment Trials and Emerging Therapeutic Targets in MS symposium GC Comi (Milan, Italy), L Kappos (Basel, Switzerland), HP Hartung (Dusseldorf, Germany) and E Havrdova (Prague, Czech Republic) presented data on monoclonal antibodies, oral treatments, cytotoxic treatments and antigen basal immune therapy. A lively discussion followed the presentations. It was clear that use of monoclonal antibodies is a promising treatment option in relapsing-remitting MS (RRMS) whilst E Havrdova reported that in the future we may be able to identify patients who could benefit from the development of a DNA vaccination. There still is a long way to go, however, as the latter therapeutic approach has been studied only in animals and there are difficulties in making successful transitions from animals models to human clinical trials.

There were two oral presentations on the trials of the emerging oral treatments: one by G Giovannoni on cladribine (UK, CLARITY study) and one by R Hohlfeld on fingolimod (Germany, FREEDOMS study) which mentioned the significant efficacy of the above drugs in RRMS patients. In particular, a substantial proportion of patients with RRMS treated with cladribine tablets were free from clinical and radiological disease activity over 96 weeks. Fingolimod, on the other hand, reduced the annualized relapse rate (ARR) compared with placebo both in patients naive to MS treatments and those who were previously treated with disease-modifying therapies.

G Riccitelly (Milan, Italy) reported that MS patients with fatigue exhibit more severe grey matter atrophy than MS patients without fatigue or healthy controls.

M Filippi (Milan, Italy) suggested that global and thalamic grey matter damage predicts the evolution of primary progressive MS at 5 years.

M Sandberg-Wollheim (Lund, Sweden) presentation based on extensive safety data, suggested that long-term treatment with interferon (IFNB)-la does not increase malignancy risk in MS patients.

L Kappos and an international group showed that the clinical effect of natalizumab appears within the first 3 months of treatment regardless of baseline disease activity. ARR was significantly lower in the natalizumab-treated group than in the placebo-treated group within the first 3 months. This effect was maintained throughout a 2-year study period. Natalizumab also prolonged the time to first relapse in two clinical studies (AFFIRM and SENTINEL).

Comprehensive information was also presented in posters:

F Mattioli et al (Brescia, Italy) showed in their study group that depression is not correlated with cognitive impairment in MS, whereas Expanded Disability Status Scale scores and fatigue are predictive factors of the occurrence of depression.

R Romano et al (Bari, Italy) found cognitive dysfunction in MS patients and suggested that functional integration between different brain areas is affected even at an early stage of demyelinating disorders.

S Petrescu et al (Bucharest, Romania) suggested a relation between the number of cortical plaques and the cognitive deficits, but not physical disability.

A Scalfari et al (London, UK) reported that accumulation of disability in MS appears to be an age-related process and not affected by the initial disease course.

MJ Alvarez-Soria et al (Ciudad Real, Spain) reported three cases which presented demyelinating disease after papilloma virus vaccination and suggested that the vaccine may have triggered an immunological mechanism.

T Counihan et al (Galway, Republic of Ireland) supported the view that MS patients exposed to Na+ channel blockers may have slower rate of disease progression.

M Wallner-Blazek on behalf of an international team analyzing atypical idiopathic inflammatory demyelinating lesions (AIIDLs) in 90 patients from the MAGNIMS centre, found that ring-like lesions appear closest to typical MS and that AIIDLs do not indicate a bad prognosis.

A Papadopoulou et al (Basel, Switzerland) reported that the use of 30 double invention recovery (DIR) sequence was of particular value as it allows identification of periaqueductal lesions in MS patients. DIR is an MRI sequence that shows the highest contrast of grey matter lesions.

N Moll et al (Cleveland, USA) in their study aimed to determine the pathological basis of magnetization transfer ratio (MTR) changes in normal-appearing white matter (NAWM) in MS. Their results indicated that MTR abnormality in NAWM of MS brains varies based on distance from focal white matter lesions

O Dolezal et al (Prague, Czech Republic) examined normal subjects for chronic cerebrospinal venous insufficiency (CCSVI) and found either the presence or signs of CCSVI in these subjects and a range of venous drainage between the people studied. He raised the question about the link between CCSVI and MS.

Overall, this meeting provided a comprehensive overview of the new developments in MS. Delegates had the opportunity to exchange ideas and data with their colleagues at one of the first European meetings of 2010.

Ioannis Milonas

Thessaloniki, Greece
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