Friday, March 31, 2006

Hopes Raised for Effectiveness of Multiple Sclerosis Drug

03/28/06 -- A national research team led by the University of Cincinnati's Bibiana Bielekova, MD, report new insights into how anti-rejection drug helps MS patients

Discovery of the mechanism of a drug being tested for the treatment of multiple sclerosis (MS) has revealed that it's not only more effective than first thought, but might also help in the management of other autoimmune diseases, organ transplant rejection and even cancer.
A research team led by the University of Cincinnati's Bibiana Bielekova, MD, report new insights into the role of the MS drug daclizumab (Zenapax) in the March 27 online version of the Proceedings of the National Academy of Sciences. The article will appear in print April 11.

The exact cause of MS is unknown, but one theory is that it may it be triggered by exposure to a viral infection or environmental influences. The disease takes different courses in different people and can go into remission for many years, recurring occasionally or progressing quickly into degeneration of all motor functions that control muscles, strength, vision and balance. The very progressive form of the disease can end in death.

Scientists have long thought that in MS the specific white cells (T-cells) that fight off infection actually turn on the body they are supposed to protect, attacking the myelin sheath that protects the nerves.

"Without the insulating cover, the nerve axons short-circuit, much like a damaged electric cord might," says Dr. Bielekova, director of UC's Waddell Center for Multiple Sclerosis. "Also, many nerve cells (neurons) do not survive without myelin sheath."

It was also believed that since activated T-cells need a growth factor called interleukin 2 for their function, drugs that can block the interaction of interleukin-2 and T-cells could be used to control MS.

Daclizumab is being tested against MS because it has already proved useful in preventing rejection of transplanted organs, "and we thought it works by inhibiting T-cell activation," Bielekova says.

Earlier research by Dr. Bielekova and her group showed that daclizumab benefits MS patients, especially those who have highly inflammatory MS. This latest study, sponsored by the National Institutes of Health (NIH), involved 22 MS patients.

"We monitored T-cell function in patients who were injected with the drug, expecting to see that the drug inhibited T-cell function," says Dr. Bielekova.

"We didn't see that at all. To our surprise the T-cells were functioning normally."

But something unexpected was happening?the numbers of T-cells circulating in the blood of patients taking daclizumab were declining by about 10 percent. Simultaneously, the number of immune cells known as "regulatory natural killer cells," which are very rare in normal human blood, increased.

Regulatory natural killer cells are known to proliferate in special conditions, such as pregnancy or bone marrow transplantation.

"Not only did the number of regulatory natural killer cells increase in patients treated with daclizumab," says Dr. Bielekova, "but that expansion correlated with the treatment outcome--the more these cells expanded, the better the MS patients did during the trial. And the longer the patients were on the therapy, the more regulatory natural killer cells they had and the better they responded to treatment."

"The best news is that natural killer cells are actually very efficient immune cells that fight viruses or cancers," says Dr. Bielekova, "so it appears that daclizumab doesn't damage the immune system. It only shifts the emphasis of the immune reaction from T-cells to natural killer cells. However, larger studies need to be performed to evaluate the safety of long-term daclizumab therapy."

The current results, however, suggest that daclizumab might also help in the management of autoimmune diseases, organ transplant rejection and perhaps even cancer, she says.

Having found one drug pathway that appears to be important for the treatment of MS, Dr. Bielekova says, "The hope is that we can learn how to enhance this pathway by drugs that can be taken orally, rather than injected." As a result of these findings by Dr. Bielekova's research team, daclizumab is now being tested as a possible MS treatment in a phase-2 trial across the United States, including UC, and Europe.

Dr. Bielekova is a member of the Neuroscience Institute, a collaborative of nine academic departments at UC College of Medicine, University Hospital and independent physician practice groups. The institute is dedicated to patient care, research, education and the development of new medical technologies.

Source: University of Cincinnati
http://www.bio.com/newsfeatures/newsfeatures_research.jhtml?cid=18300033

Thursday, March 30, 2006

Biogen Idec and Elan Announce Re-Initiation of TYSABRI(R) Clinical Trial Dosing in Multiple Sclerosis

Biogen Idec and Elan Announce Re-Initiation of TYSABRI(R) Clinical Trial Dosing in Multiple Sclerosis
RedNova Wed, 29 Mar 2006 4:05 PM PST
Biogen Idec (NASDAQ: BIIB) and Elan Corporation, plc. (NYSE: ELN) announced today that they have enrolled and dosed the first patients in the TYSABRI(R) (natalizumab) monotherapy safety extension study program in multiple sclerosis (MS).

Cannabis truly helps multiple sclerosis sufferers
New Scientist Wed, 29 Mar 2006 11:09 PM PST
Long-term use of therapeutic cannabinoids appears to offer real muscular benefits to patients - not just a boost in mood

How Many Americans Have Multiple Sclerosis? No One Knows With Absolute Certainty
Medical News Today Wed, 29 Mar 2006 3:08 PM PST
No one knows with absolute certainty how many people in the U.S. are diagnosed with MS every year ("incidence") or how many have MS right now ("prevalence"), although the National MS Society estimates that about 400,000 people have the disease. Steps are now being taken by a federal agency and by the National MS Society to rectify this uncertainty, including a proposal to develop a national

Biogen, Elan retest MS drug, see FDA action by June
Reuters via Yahoo! News Wed, 29 Mar 2006 5:41 PM PST
Biogen Idec and Elan Corp said on Wednesday they have restarted a safety trial of its multiple sclerosis drug Tysabri, which the drugmakers recalled from the market after reports of rare brain infection were linked to the drug.

Higher wages may cut health care
Detroit News Thu, 30 Mar 2006 1:17 AM PST
CLINTON TOWNSHIP -- There are few things David DeMotigny can do for himself anymore. At 44 years old, multiple sclerosis essentially has left him paralyzed.

Cork GP under investigation in stem-cell therapy allegation
Irish Examiner Thu, 30 Mar 2006 1:43 AM PST
A GP in Co Cork is reportedly under investigation for allegedly providing controversial stem-cell therapies to multiple sclerosis sufferers.

Vaccine could stop MS in its tracks
New Scientist Wed, 29 Mar 2006 11:33 PM PST
The immune cells that attack the brain and nerves of people with multiple sclerosis could be turned into a weapon against the disease

Biogen, Elan retest MS drug, see FDA action by June
RedNova Wed, 29 Mar 2006 8:29 PM PST
CHICAGO (Reuters) - Biogen Idec and Elan Corp said on Wednesday they have restarted a safety trial of its multiple sclerosis drug Tysabri, which the drugmakers recalled from the market after reports of rare brain infection were linked to the drug. A U.S.

Watchdog probes MS stem cell therapy
Irish Examiner Wed, 29 Mar 2006 4:27 PM PST
By Claire O’Sullivan THE Irish Medicines Board is investigating the provision of stem cell therapy to multiple sclerosis sufferers at a cost of €18,500 for a three-hour session.

Biogen, Elan Re-Launch Tysabri Trial
RedNova Wed, 29 Mar 2006 4:07 PM PST
Biogen Idec and Elan said Wednesday they are re-launching human trials of multiple sclerosis treatment Tysabri.

Biogen Idec and Elan Announce Re-Initiation of TYSABRI(R) Clinical ...

Biogen Idec and Elan Announce Re-Initiation of TYSABRI(R) Clinical ...
Financial News USA (press release) - La Puente,CA,USA
announced recently that they have enrolled and dosed the first patients in the TYSABRI® (natalizumab) monotherapy safety extension study program in multiple ...

Elan and Biogen Idec resume safety study on Tysabri
Ireland Online - Dublin,Ireland
Elan Corporation and its partner Biogen Idec have confirmed that they have resumed a safety study on their controversial MS drug Tysabri. ...
See all stories on this topic

Healthcare Industry Today Offers Extended News Coverage of Tysabri ...
PR Newswire (press release) - New York,NY,USA
See: * Drugs News - http://www.healthcareindustrytoday.com/category/Drugs/pr * Tysabri News - http://www.healthcareindustrytoday.com/news/Tysabri/pr * Lipitor ...
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Clinical Trials for Multiple Sclerosis


Clinical trials are research studies conducted in an effort to improve overall patient health and care. Each trial involves running supervised tests to determine the effectiveness and safety of new drugs, procedures and/or devices with the aim of answering scientific questions about a disease or condition. Risks and side-effects are also evaluated during these trials with results ranging from being unpleasant, with side effects such as headaches, to more serious or even life-threatening risks.

A clinical trial may be separated into phases, or steps, with each step designed to answer a separate research question. This maybe reflected in the trial name.

A brief description of each phase:

  • Phase I: Usually designed to evaluate safety, determine a safe dosage range, and identify side effects on a small group of patients.
  • Phase II: If Phase I is successful, the trial is then repeated with a larger group to further evaluate its effect and safety.
  • Phase III: Trials are conducted on an ever larger group and are compared with the best current treatment while gathering more information on effect and safety.
  • Phase IV: These studies monitor long-term side effects after the treatment has been marketed.

Clinical Trials data for Multiple Sclerosis is grouped into the following categories:-

Clinical Trials by trial name
The format for each of the following is:

  • The name of the trial,
  • followed by whether the trial is recruiting patients,
    - The trial may not have started and not yet recruiting, or the trial may have started and do not need any more recruitements, or the trial may be completed.
    - Note**: Please follow the link to determine the current trial status.
  • followed by a list of drug/s, if any, used in the trial
ClinicalTrials.gov has listed the following trials for Multiple Sclerosis:

Drugs used in Clinical Trials for Multiple Sclerosis
The format for each of the following is:

  • The drug,
  • followed by the name of the trial,
  • followed by whether the trial is recruiting patients,
    - The trial may not have started and not yet recruiting, or the trial may have started and do not need any more recruitements, or the trial may be completed.
    - Note**: Please follow the link to determine the current trial status.
ClinicalTrials.gov has listed the following drugs in trials for Multiple Sclerosis:
http://www.wrongdiagnosis.com/m/multiple_sclerosis/trials.htm

Glandular fever linked to MS

Glandular fever linked to MS
Nursing Times Wed, 29 Mar 2006 4:20 AM PST
Contracting glandular fever (infectious mononucleosis) in adolescence raises the risk of multiple sclerosis in later life, according to new research. A study published in the Annals of Neurology combined 14 relevant studies conducted in the US, Europe, and Australia to come up with an overall picture of the connection between infectious mononucleosis and MS.

Home-health nurse will face trial on theft charges
Times Leader Wed, 29 Mar 2006 0:10 AM PST
WILKES-BARRE – Charges against a home-health nurse accused of stealing from a wheelchair-bound multiple sclerosis patient whom she cared for were forwarded to county court on Tuesday.

Wednesday, March 29, 2006

IRC recruits MS panel to advise on vaccine

IRC recruits MS panel to advise on vaccine

CARLSBAD, Calif., March 29 (UPI) -- The Immune Response Corp. said Wednesday it has formed an expert board to advise on its multiple sclerosis (MS) vaccine NeuroVax.

"We are honored to have six of the leading minds in MS research working with us to guide the development of NeuroVax," said Joseph O'Neill, CEO and president of IRC.

"Our clinical findings indicate that NeuroVax induces strong, disease-specific immune responses in essentially all the MS patients treated," he said.

O'Neill added, "We are eager to continue with additional Phase II studies and will launch a 300-patient trial later this year in Eastern Europe and the United States that will test the clinical benefit of NeuroVax by assessing its effect on MRI and relapse rates."

IRC said recent studies show that part of the immune response triggered by NeuroVax is the stimulation of so-called "FOXP3+ Regulatory T-cells," an approach the company said shows promise in treating MS and other autoimmune disorders, such as rheumatoid arthritis, psoriasis and Crohn's disease.

The company said its studies have shown that MS patients have diminished levels of FOXP3 message and protein expression levels in their peripheral T-cells, a revelation that IRC said marks the first time that a defect in functional peripheral immunoregulation has been linked to an established genetic marker, FOXP3.

FOXP3 plays a role in maintaining immune tolerance and repressing the development of autoimmune diseases such as MS, IRC said.

The six neurology experts recruited by IRC to sit on its NeuroVax advisory board are:

Jack Antel, professor in the Department of Neurology and Neurosurgery at McGill University.

Dennis Bourdette, director of the MS Center of Oregon and chair of the Department of Neurology at Oregon Health and Science University (OHSU).

Giancarlo Comi, director of the Department of Neurology and Clinical Neurophysiology at San Raffaele Hospital in Milan, Italy.

Krzysztof Selmaj, chairman of the Department of Neurology at the Medical University in Lodz, Poland.

Arthur Vandenbark, senior research career scientist at the Portland Veterans Affairs Medical Center, and professor in the Departments of Neurology and Molecular Microbiology and Immunology at OHSU.

Jerry Wolinsky, director of the Multiple Sclerosis Research Group and the Magnetic Resonance Imaging Analysis Center at the Graduate School of Biomedical Sciences at the University of Texas Health Science Center in Houston.

http://www.upi.com/HealthBusiness/view.php?StoryID=20060329-014903-8019r

Biogen Idec, Elan resume Tysabri trials

Biogen Idec, Elan resume Tysabri trials
BusinessWeek - USA
... said Wednesday they have resumed Tysabri trials and dosed the first patients in the monotherapy safety extension study program for multiple sclerosis. ...
See all stories on this topic

Biogen-Tysabri reinitiate Tysabri trial
Eyewitness News - East Providence,RI,USA
NEW YORK Biogen Idec and Elan Corporation have resumed trials of the multiple sclerosis drug Tysabri (ty-SAH'-bree). It was pulled ...

PharmaFrontiers to Present Data on Adult Human T-Cell and Stem ...

PharmaFrontiers to Present Data on Adult Human T-Cell and Stem ...
Genetic Engineering News - Larchmont,NY,USA
... The lead T-cell vaccination product for the treatment of multiple sclerosis, Tovaxin(TM), is composed of myelin reactive T-cells (MRTC) against the three major ...

Monday, March 27, 2006

FDA Statement on Tysabri Review Time

FDA Statement on Tysabri Review Time
Kansas City infoZine - Kansas City,MO,USA
... on March 22, 2006, that the Food and Drug Administration (FDA) had extended the regulatory review period for the reintroduction of Tysabri (natalizumab) for ...
See all stories on this topic

Wonder drugs don’t exist for MS; stick with proven options

Wonder drugs don’t exist for MS; stick with proven options
Fort Wayne Journal Gazette - Fort Wayne,IN,USA
... confirm. What do you think of low-dose naltrexone and NeuroVax? ... cells. NeuroVax is in very early trials and is not yet approved by the FDA. ...

FDA Delays Final Decision on Tysabri Until Late June

FDA Delays Final Decision on Tysabri Until Late June
Newsinferno.com - New York,NY,USA
Once an advisory panel voted unanimously to recommend that Tysabri, the controversial MS drug, be allowed back on the market, it was assumed that the FDA would ...

FDA will try to make Tysabri decision before end of June
MarketWatch - USA
... Drug Administration said Friday it would try to make a final decision before the end of June on whether to allow the multiple-sclerosis drug Tysabri back on ...
See all stories on this topic

Elan falls by 8pc as FDA delays Tysabri
Unison.ie - Bray,Ireland
... drugmaker Elan dropped 8pc yesterday to finish at €11.20 after the company suffered a new setback on the return of its multiple sclerosis drug Tysabri to the ...

Ruling on MS Drug Tysabri Delayed
Los Angeles Times - CA,USA
... said in a joint statement that the Food and Drug Administration had postponed until June 28 a decision on whether to re-approve the drug, called Tysabri. ...

Saturday, March 25, 2006

Elan, Biogen say FDA to extend review on Tysabri

Elan, Biogen say FDA to extend review on Tysabri
Reuters - USA
... Quote, Profile, Research) and Biogen Idec (BIIB.O: Quote, Profile, Research) faced a fresh delay in getting their multiple sclerosis treatment Tysabri back to ...

Elan Says US Regulator Delays Tysabri for 90 Days (Update2)
Bloomberg - USA
... said US regulators delayed the possible return of their multiple sclerosis treatment Tysabri to study the companies' safety plan for resuming sales of the ...

FDA to extend review on Tysabri - companies
Reuters - USA
... Elan (ELN.I: Quote, Profile, Research) and Biogen Idec (BIIB.O: Quote, Profile, Research) it will extend its regulatory review of their Tysabri treatment for ...

Makers of MS drug Tysabri say FDA delaying verdict on drug's sale ...
Canada.com - Hamilton,Ontario,Canada
... of a suspended multiple sclerosis drug said Wednesday that American regulators have delayed until June their decision on whether to permit Tysabri to return to ...

FDA to extend Tysabri review
MarketWatch - USA
LONDON (MarketWatch) -- The US Food and Drug Administration has decided to extend its review of the multiple sclerosis drug Tysabri by up to 90 days, Elan and ...

FDA says Tysabri review a high priority
Reuters - USA
WASHINGTON (Reuters) - A review of Biogen Idec and Elan's bid to return multiple sclerosis drug Tysabri to the market "continues to be a high priority," the ...
See all stories on this topic

New Speedbump for Tysabri
TheStreet.com - USA
... Elan (ELN:NYSE - commentary - research - Cramer's Take) suffered a setback Wednesday when the FDA said it wanted another 90 days to review Tysabri, the multiple ...

Elan, Biogen say FDA to extend review on Tysabri
ABC News - USA
... Reuters) - The US Food and Drug Administration has told drug firms Elan and Biogen Idec it will extend its regulatory review of their Tysabri treatment for ...

Elan Says US Regulator Delays Tysabri for 90 Days (Update3)
Bloomberg - USA
... said US regulators delayed the possible return of the multiple sclerosis drug Tysabri to review the companies' plan to prevent a rare side effect that killed ...

Friday, March 24, 2006

Tysabri delayed as rivals gird

The Boston Globe

Biogen's competitors in $5.3b market hope to undermine return of a therapy shown to be more effective than peers

By Jeffrey Krasner, Globe Staff | March 23, 2006

While a decision on whether to bring Tysabri back to the market is on hold, makers of competing multiple sclerosis drugs are already preparing for its return.

With a worldwide market for MS drugs of over $5 billion at stake, they are working on ways to blunt the impact of Tysabri, which has proven twice as effective in preventing debilitating relapses of the disease as existing treatments. The drug, made by Biogen Idec Inc. of Cambridge and Elan Corp. of Ireland, was pulled from the market last year after being linked to a rare but deadly brain disease.

Well before federal advisers this month unanimously decided to recommend that the FDA allow Tysabri to be sold again, Serono SA, the Swiss biopharmaceutical giant, was girding for renewed competition for its MS drug, Rebif.

''We do see a possibility of Tysabri coming back, and we have our own internal battle plan to combat reentry," said chief financial officer Stuart Grant in a recent interview with Dow Jones.

Local officials of Serono, which has US headquarters in Rockland, declined to discuss the plan. But the company sponsored a telephone briefing for science writers about multiple sclerosis a week before the FDA advisory committee meeting. The briefing was cosponsored by Pfizer, which also markets Rebif in the United States.

The phone session was one of a flurry of recent activities involving Tysabri competitors, although the companies said they weren't timed to coincide with the advisory meeting.

Just before the advisory vote, a publicist for Teva Neurosciences Inc. steered reporters to an embargoed scientific paper highlighting potential adverse effects on the immune system caused by Tysabri. Teva is the US arm of an Israeli generic-drug maker, which also manufactures the MS drug Copaxone. It is also sponsoring a series of briefings for physicians on progressive multifocal leukoencephalopathy, or PML, the rare brain disease that was tied to three patients who took Tysabri in clinical trials.

The company did not return phone calls seeking comment.

''Our effort to bring Tysabri back to MS patients is our attempt to provide them with new hope and additional choices," said Biogen Idec spokesman Tim Hunt. ''In contrast, a small number of drug companies are clearly putting corporate profits ahead of patients."

For years, the MS market has been dominated by four drugs. Biogen Idec's Avonex is the leader, with 2005 sales of about $1.5 billion. Serono's Rebif, which is chemically identical to Avonex but has a different dosing regimen, had sales of nearly $1.3 billion. Teva's Copaxone achieved sales of nearly $1.2 billion, and Schering AG's Betaseron reached sales of nearly $1.1 billion last year.

In addition to its unparalleled effectiveness, Tysabri may have an advantage in how it is administered. Patients received Tysabri in a monthly intravenous infusion performed at a doctor's office. The other MS drugs are taken as injections at home, once a week for Avonex and several times a week for the others.

Some analysts expect Tysabri to capture sales from the existing drugs and expand the overall market by attracting patients who have discontinued treatment -- particularly if the drug is approved for first-line treatment, meaning that it could be prescribed before established drugs had been tried. Second-line status would restrict it to patients who aren't responding to other treatments.

According to stockbrokers Rodman & Renshaw, an estimated 26 percent of MS patients take one of the top four treatments now available. The other patients either haven't started treatment, have discontinued treatment because they are unhappy with the results or side effects, or have an aggressive form of MS for which there are no approved treatments.

When Tysabri was on sale between November 2004 and February 2005, Biogen Idec and Elan sold it for about $23,500 for a year's treatment, according to Biogen Idec. Most other MS drugs cost about $20,000 annually. Biogen Idec declined to say what it will charge for Tysabri when it is reintroduced, but some analysts expect it to start at the same price.

Wall Street expected the drug to be a blockbuster, with annual sales of more than $3 billion, but those forecasts were made before it was withdrawn from the market. Biogen Idec and Elan spent much of last year conducting a safety review, which did not uncover any additional cases of the disease. Last fall, they filed an application with the FDA for renewed approval to sell Tysabri.

Mike Luby, chief executive of TargetRX, a Pennsylvania consulting firm specializing in pharmaceutical marketing, said competitors can deal with Tysabri's impending return in three ways.

''The first is to ignore it," Luby said. ''The second is to remind physicians and patients of the uncertainty surrounding the drug. You're not bashing the drug, but there are potentially serious side effects. The third is to position Tysabri in a very narrow niche -- something we call embrace and smother."

Teva, for example, could indirectly be highlighting the risks of Tysabri through its PML calls. Serono seems to be pursuing the third strategy: embrace and smother. In an interview just after the FDA advisory committee's vote, Andrew Galazka, Serono's senior vice president of scientific affairs, called Tysabri a drug of ''last resort."

''Tysabri's risks are not yet well understood," Galazka told Dow Jones.

Before Tysabri's introduction, Serono officials predicted Rebif, which went on sale in the United States in March 2002, would be the biggest-selling MS drug in the country by the end of 2006. But it is still in third place, and the company has now set its sights on becoming number two, Galazka said. Meantime, Serono has put itself up for sale, but has yet to attract a buyer.

Biogen Idec, which relied on the MS drug Avonex for 63 percent of its $2.42 billion in 2005 revenue, said campaigns to dissuade doctors and patients from using Tysabri are attempts by competitors to protect their business.

A doctor who contributed to Teva's PML program and Serono's science-writer call said he isn't trying to promote either drug.

''My intention is to provide a service," said Dr. Bruce Cohen, professor of neurology at the Feinberg School of Medicine at Northwestern University in Chicago. ''I'm not making any attempt to persuade people to take a particular drug or not take a particular drug. Obviously, anything that's sponsored by a pharmaceutical company has a cloud over it in some people's eyes."

Cohen said he accepts speaking fees from Biogen Idec, Serono, Teva, and Schering AG, which markets another MS treatment through its US subsidiary, Berlex.

Jeffrey Krasner can be reached at krasner@globe.com.
© Copyright 2005 The New York Times Company


http://www.boston.com/business/healthcare/articles/2006/03/23/tysabri_delayed_as_rivals_gird/?page=full