As many of us know, the neurological disease Multiple Sclerosis (MS) has multiple forms :
- Relapsing-Remitting (RRMS): Unpredictable attacks (relapses) followed by periods of relative remission with no new signs of disease activity
- Secondary Progressive (SPMS) : Neurologic decline without acute relapses: A sign that one is evolving from RRMS to SPMS is that the baseline drugs[ CRABT] work less well (Copaxone, Rebif, Avonex, Betaseron and Tysabri); Disability has progressed. This group is fairly large : about 50 % of RRMS evolves into SPMS within age 40.
- Progressive Relapsing (PRMS) : Steady neurologic decline and superimposed attacks.
- Primary Progressive (PPMS) : Decline from the beginning without attacks; problems walking, which gradually get worse; slowly worsening tremor; problems with balance.
Most Multiple Sclerosis (MS) new drugs, (See for example, our post on Alemtuzumab ), apply primarily to the Relapsing Remitting Multiple Sclerosis form.
We have posted through the year on the Progressive forms of MS [4-8], and checking on current research, we gathered the following.
First we bring you, through YouTube, a presentation by Dr Yaung Mao-Drayer, U. Of Michigan . This is a good summary of the challenges of treating progressive MS.
The most important Chart of this presentation is below. Progressive MS according to Dr Mao-Draayer
Here you would have it, most , if not all the MS big guns address the inflammation phase of RRMS, as opposed to the Neuro-Degenerative phase of the progreesive types of MS.
Is it really that simple?
- Another study from Denmark , shows that inflammation and neurodegeneration go and progress hand in hand : “…emphasise a relationship between inflammation, axonal damage and demyelination…”
- From Austria : “...In progressive MS, as in relapsing-remitting MS, active tissue injury is associated with inflammation, but the inflammatory response in the progressive phase occurs at least partly behind the blood-brain barrier, which makes it more difficult to treat.
- Stem Cells: Stem cells that can differentiate into a variety of cell types, including blood cells 
- Masitinib ”… Masitinib, a selective oral tyrosine kinase inhibitor, effectively inhibits the survival, migration and activity of mast cells…”
- Statins: Usually for cholesterol concerns, Zocor (Simvastatin) 
- About.com ; Julie Stachowiak
- medinewsdigest ; “Big Pharma’s Slight Of Hand: Genzyme’s Alemtuzumab Disappears as a Leukemia Drug, Only To Be Reborn as a Multiple Sclerosis Drug”, Nov 2012
- medinewsdigest ; IN BRIEF: Management of Secondary Progressive Multiple Sclerosis” ;April 2012
- medinewsdigest ; “Progress in Stem Cell Treatment of Secondary Progressive Multiple Sclerosis” ; Feb 2012
- medinewsdigest ; “Possible New Treatment of Progressive Multiple Sclerosis: Masitinib” ; June 2012
- medinewsdigest ; “IN DEPTH: Multiple Sclerosis Research And The Blood Brain Barrier” ; Aug 2012
- medinewsdigest ; “IN BRIEF: Zocor Shown to Slow Disability in Secondary Progressive Multiple Sclerosis” ; Oct 2012
- medinewsdigest ; “New Study shows Multiple Sclerosis caused primarily by inflammation, not neurodegeneration” , Dec 2011
- youtube; “Progressive Multiple Sclerosis – 2012 Patient & Caregiver Conference”
- Multiple Sclerosis ; ” CSF inflammation and axonal damage are increased and correlate in progressive multiple sclerosis.”; Nov 2012
- Nature Reviews Neurology ; “Progressive multiple sclerosis: pathology and pathogenesis.” ; Nov 2012 Multiple Sclerosis ; “Intravenous immunoglobulin in primary and secondary chronic progressive multiple sclerosis: a randomized placebo controlled multicentre study.” ; Nov 2007
- Journal of Controlled Release ; “Transport of drugs across the blood-brain barrier by nanoparticles.”; July 2012
- Int. Journal Of Molecular Science ; “Mechanisms of Oxidative Damage in Multiple Sclerosis and Neurodegenerative Diseases: Therapeutic Modulation via Fumaric Acid Esters.” ; 2012
- Alternative Holistic Health Answers ; “Study Confirms Efficacy of Oral Fumarate in Multiple Sclerosis” ; Christopher Maloney, Naturopathic Doctor, April 2012
- uptodate.com ; “Treatment of progressive multiple sclerosis in adults” ; Oct 2012
- Multiple Sclerosis Journal ; “Setting a research agenda for progressive multiple sclerosis: The International Collaborative on Progressive MS” ; 2012