‘Advance and Transfer’ in MS Treatments
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I was diagnosed with multiple sclerosis (MS) in April of 2001. Only three disease-modifying therapies (DMTs) were on the market then.
With the recent FDA approval of the first biosimilar medication for MS, I’ve honestly lost track of how many DMTs are on the market. (Where you live and under which drug approval authority make a difference as well.)
Powerful Drugs, Potentially Powerful Side Effects
As the medications have become stronger and more effective, so too have the side effects, or adverse events, they can bring on.
Many of us remember the shock of reading that people were contracting and even dying of progressive multifocal leukoencephalopathy (PML) — a viral infection of the brain associated with the JC (John Cunningham) virus — as a result of taking one, and then another, DMT.
We move forward … but that movement can have unintended results.
How a Big Ship Turns
Two papers I read recently brought to mind a concept that I remember from my days as a ship’s navigator in the U.S. Coast Guard. The term for the concept is “advance and transfer.”
Ships don’t turn on a dime. So when charting out a course particularly in dangerous waters — it is important to know how far forward your ship continues to advance before you settle on a new course after you turn the rudder. This is the “advance.”
One must also calculate how far down the new track line you will be before you settle on the new course. This is the “transfer.”
A drawing may help to visualize this.
Stem Cell Treatments Advance
While it’s not an exact analogy, I thought of advance and transfer when reading two recent studies about stem cell treatment for MS, of which there are at least a couple of different types, according to the National Multiple Sclerosis Society.
One study, which looked at how people who had undergone autologous hematopoietic stem cell transplantation (aHSCT) fared over time, offered up real hope for people with MS when it came to this advanced (if invasive) procedure.
“Most patients with relapsing-remitting multiple sclerosis treated with autologous hematopoietic stem cell transplantation showed no evidence of disease activity for 5 to 10 years, observational data showed,” the researchers wrote.
That’s great news! An advance. (You’re seeing that it’s not an exact analogy, aren’t you?)
… and Transfer
Then came another article, this one published by the U.S. Centers for Disease Control and Prevention. It’s the transfer.
It outlines one (of many) cases of unintended infection, disease, or trauma that have occurred when people seek treatments — which may not be available to them at home — in other countries. It’s called “medical tourism.”
This particular case involved a woman with MS who traveled out of the United States for intrathecal injections of donor umbilical cord stem cells said to be programmed to treat MS. (“Intrathecal” means the cells were injected directly into the fluid around the spinal cord.) The treatment resulted in a severe bacterial infection that took weeks to identify, and longer to treat.
In contrast to the previous paper, the authors of this paper concluded, “There is no proven benefit to intrathecal stem cell treatments, and such treatments should be offered only through registered clinical trials.”
No Straight Path to Success
Things move forward, but they also move sideways. Medical research advances, but there is also a transfer of momentum as things change. It’s sort of the physics of living with an incurable disease that we want cured, and that medical researchers want to cure.
Wishing you and your family the best of health.
Cheers,
Trevis
My book Chef Interrupted is available on Amazon. Follow me on the Life With MS Facebook page, and read more on Life With Multiple Sclerosis.
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