MS Briefs

Key clinical point: Physical exercise significantly reduces fatigue in patients with multiple sclerosis (MS).

Major finding: The standardized mean difference between the intervention groups before and after the intervention was estimated to be 23.8±6.2 and 16.9±3.2, respectively.

Study details: Meta-analysis of 31 studies including 1,434 participants (714 in the intervention group; 720 in the control group).

Disclosures: This study was funded by the Student Research Committee of Kermanshah University of Medical Sciences, Deputy for Research and Technology, Kermanshah University of Medical Sciences. The authors declared no conflict of interest.

Citation: Razazian N et al. BMC Neurol. 2020 Mar 13. doi: 10.1186/s12883-020-01654-y. 

Key clinical point: Physical exercise significantly reduces fatigue in patients with multiple sclerosis (MS).

Major finding: The standardized mean difference between the intervention groups before and after the intervention was estimated to be 23.8±6.2 and 16.9±3.2, respectively.

Study details: Meta-analysis of 31 studies including 1,434 participants (714 in the intervention group; 720 in the control group).

Disclosures: This study was funded by the Student Research Committee of Kermanshah University of Medical Sciences, Deputy for Research and Technology, Kermanshah University of Medical Sciences. The authors declared no conflict of interest.

Citation: Razazian N et al. BMC Neurol. 2020 Mar 13. doi: 10.1186/s12883-020-01654-y. 

Key clinical point: Physical exercise significantly reduces fatigue in patients with multiple sclerosis (MS).

Major finding: The standardized mean difference between the intervention groups before and after the intervention was estimated to be 23.8±6.2 and 16.9±3.2, respectively.

Study details: Meta-analysis of 31 studies including 1,434 participants (714 in the intervention group; 720 in the control group).

Disclosures: This study was funded by the Student Research Committee of Kermanshah University of Medical Sciences, Deputy for Research and Technology, Kermanshah University of Medical Sciences. The authors declared no conflict of interest.

Citation: Razazian N et al. BMC Neurol. 2020 Mar 13. doi: 10.1186/s12883-020-01654-y. 

Key clinical point: In patients with relapsing-remitting multiple sclerosis (RRMS), both fingolimod (FIN) and natalizumab (NTZ) reduce the annualized relapse rate (ARR), but ARR percent reduction is significantly higher with NTZ after 12 months of treatment.

Major finding: ARR reduction during the first year of treatment was statistically significant in both the groups, from 1.67±0.98 to 0.28±0.62 in the FIN group and from 1.71±1.37 to 0.12±0.33 in the NTZ group (P less than .0001 for both). Nevertheless, the ARR percent reduction was significantly higher in the NTZ group vs. FIN group during the first year of treatment (92.3% vs. 81.8%; P = .0064).

Study details: Retrospective, observational study compared the ARR over the first year in 314 patients with RRMS after the treatment with FIN (n = 184) or NTZ (n = 130) as a second-line therapy in routine clinical practice in Spain.

Disclosures: This study was funding by Novartis Farmaceutica, S.A. The authors declared no conflicts of interest.

Citation: Meca-Lallana J et al. Eur Neurol. 2020 Mar 18. doi: 10.1159/000505778. 

Key clinical point: In patients with relapsing-remitting multiple sclerosis (RRMS), both fingolimod (FIN) and natalizumab (NTZ) reduce the annualized relapse rate (ARR), but ARR percent reduction is significantly higher with NTZ after 12 months of treatment.

Major finding: ARR reduction during the first year of treatment was statistically significant in both the groups, from 1.67±0.98 to 0.28±0.62 in the FIN group and from 1.71±1.37 to 0.12±0.33 in the NTZ group (P less than .0001 for both). Nevertheless, the ARR percent reduction was significantly higher in the NTZ group vs. FIN group during the first year of treatment (92.3% vs. 81.8%; P = .0064).

Study details: Retrospective, observational study compared the ARR over the first year in 314 patients with RRMS after the treatment with FIN (n = 184) or NTZ (n = 130) as a second-line therapy in routine clinical practice in Spain.

Disclosures: This study was funding by Novartis Farmaceutica, S.A. The authors declared no conflicts of interest.

Citation: Meca-Lallana J et al. Eur Neurol. 2020 Mar 18. doi: 10.1159/000505778. 

Key clinical point: In patients with relapsing-remitting multiple sclerosis (RRMS), both fingolimod (FIN) and natalizumab (NTZ) reduce the annualized relapse rate (ARR), but ARR percent reduction is significantly higher with NTZ after 12 months of treatment.

Major finding: ARR reduction during the first year of treatment was statistically significant in both the groups, from 1.67±0.98 to 0.28±0.62 in the FIN group and from 1.71±1.37 to 0.12±0.33 in the NTZ group (P less than .0001 for both). Nevertheless, the ARR percent reduction was significantly higher in the NTZ group vs. FIN group during the first year of treatment (92.3% vs. 81.8%; P = .0064).

Study details: Retrospective, observational study compared the ARR over the first year in 314 patients with RRMS after the treatment with FIN (n = 184) or NTZ (n = 130) as a second-line therapy in routine clinical practice in Spain.

Disclosures: This study was funding by Novartis Farmaceutica, S.A. The authors declared no conflicts of interest.

Citation: Meca-Lallana J et al. Eur Neurol. 2020 Mar 18. doi: 10.1159/000505778. 

Key clinical point: Low serum levels of vitamin D are inversely associated with clinical and disease activity in patients with multiple sclerosis (MS).

Major finding: Patients with serum 25(OH)D levels ≥30 ng/mL group had lower median T2-weighted lesion counts than those with <30 ng/mL  (P = .03; adjusted for age, sex, 25(OH)D levels, and disease duration, P less than .001). Expanded disability status scale (EDSS) score had an inverse association with serum 25(OH)D levels after adjusting for age, sex, and disease duration (adjusted P less than .001).

Study details: The study analyzed baseline serum vitamin D levels of patients recruited in the randomized Efficacy of Vitamin D Supplementation in Multiple Sclerosis (EVIDIMS) study.

Disclosures: The study was funded by the German Research Organization grants awarded to FP and JD, the Einstein Foundation Berlin, and a limited research grant from Bayer Leverkusen, Germany. Priscilla Bäcker-Koduah, Judith Bellmann-Strobl, Jens Wuerfel, Jan Dörr, Alexander Ulrich Brandt, Friedemann Paul, Klaus-Dieter Wernecke reported ties with one or more pharmaceutical companies. Michael Scheel reported no conflicts of interest.

Citation: Bäcker-Koduah P et al. Front Neurol. 2020 Feb 25. doi: 10.3389/fneur.2020.00129.

Key clinical point: Low serum levels of vitamin D are inversely associated with clinical and disease activity in patients with multiple sclerosis (MS).

Major finding: Patients with serum 25(OH)D levels ≥30 ng/mL group had lower median T2-weighted lesion counts than those with <30 ng/mL  (P = .03; adjusted for age, sex, 25(OH)D levels, and disease duration, P less than .001). Expanded disability status scale (EDSS) score had an inverse association with serum 25(OH)D levels after adjusting for age, sex, and disease duration (adjusted P less than .001).

Study details: The study analyzed baseline serum vitamin D levels of patients recruited in the randomized Efficacy of Vitamin D Supplementation in Multiple Sclerosis (EVIDIMS) study.

Disclosures: The study was funded by the German Research Organization grants awarded to FP and JD, the Einstein Foundation Berlin, and a limited research grant from Bayer Leverkusen, Germany. Priscilla Bäcker-Koduah, Judith Bellmann-Strobl, Jens Wuerfel, Jan Dörr, Alexander Ulrich Brandt, Friedemann Paul, Klaus-Dieter Wernecke reported ties with one or more pharmaceutical companies. Michael Scheel reported no conflicts of interest.

Citation: Bäcker-Koduah P et al. Front Neurol. 2020 Feb 25. doi: 10.3389/fneur.2020.00129.

Key clinical point: Low serum levels of vitamin D are inversely associated with clinical and disease activity in patients with multiple sclerosis (MS).

Major finding: Patients with serum 25(OH)D levels ≥30 ng/mL group had lower median T2-weighted lesion counts than those with <30 ng/mL  (P = .03; adjusted for age, sex, 25(OH)D levels, and disease duration, P less than .001). Expanded disability status scale (EDSS) score had an inverse association with serum 25(OH)D levels after adjusting for age, sex, and disease duration (adjusted P less than .001).

Study details: The study analyzed baseline serum vitamin D levels of patients recruited in the randomized Efficacy of Vitamin D Supplementation in Multiple Sclerosis (EVIDIMS) study.

Disclosures: The study was funded by the German Research Organization grants awarded to FP and JD, the Einstein Foundation Berlin, and a limited research grant from Bayer Leverkusen, Germany. Priscilla Bäcker-Koduah, Judith Bellmann-Strobl, Jens Wuerfel, Jan Dörr, Alexander Ulrich Brandt, Friedemann Paul, Klaus-Dieter Wernecke reported ties with one or more pharmaceutical companies. Michael Scheel reported no conflicts of interest.

Citation: Bäcker-Koduah P et al. Front Neurol. 2020 Feb 25. doi: 10.3389/fneur.2020.00129.

Key clinical point: Continuation of natalizumab during the first trimester may lower the risk for disease reactivation during pregnancy in patients with active multiple sclerosis (MS).

Major finding: The secured first trimester (SFT) group vs secured conception (SC) group was associated with lower rates of relapse (3.6% vs 38.5%; P = .008) and disability progression (3.6% vs 30.8%; P = .03) during pregnancy.

Study details: Two strategies were compared for women with active MS planning to conceive: stopping natalizumab at the end of the first trimester (SFT, n = 29) and stopping at conception (SC, n = 14).

Disclosures: The study did not receive any funding. Audrey Rico, Adil Maarouf, Clémence Boutiere, Jean Pelletier and Bertrand Audoin reported ties with one or more pharmaceutical companies. Sarah Demortiere reported no disclosures.  

Citation: Demortiere S et al. Mult Scler. 2020 Mar 23. doi: 10.1177/1352458520912637.

Key clinical point: Continuation of natalizumab during the first trimester may lower the risk for disease reactivation during pregnancy in patients with active multiple sclerosis (MS).

Major finding: The secured first trimester (SFT) group vs secured conception (SC) group was associated with lower rates of relapse (3.6% vs 38.5%; P = .008) and disability progression (3.6% vs 30.8%; P = .03) during pregnancy.

Study details: Two strategies were compared for women with active MS planning to conceive: stopping natalizumab at the end of the first trimester (SFT, n = 29) and stopping at conception (SC, n = 14).

Disclosures: The study did not receive any funding. Audrey Rico, Adil Maarouf, Clémence Boutiere, Jean Pelletier and Bertrand Audoin reported ties with one or more pharmaceutical companies. Sarah Demortiere reported no disclosures.  

Citation: Demortiere S et al. Mult Scler. 2020 Mar 23. doi: 10.1177/1352458520912637.

Key clinical point: Continuation of natalizumab during the first trimester may lower the risk for disease reactivation during pregnancy in patients with active multiple sclerosis (MS).

Major finding: The secured first trimester (SFT) group vs secured conception (SC) group was associated with lower rates of relapse (3.6% vs 38.5%; P = .008) and disability progression (3.6% vs 30.8%; P = .03) during pregnancy.

Study details: Two strategies were compared for women with active MS planning to conceive: stopping natalizumab at the end of the first trimester (SFT, n = 29) and stopping at conception (SC, n = 14).

Disclosures: The study did not receive any funding. Audrey Rico, Adil Maarouf, Clémence Boutiere, Jean Pelletier and Bertrand Audoin reported ties with one or more pharmaceutical companies. Sarah Demortiere reported no disclosures.  

Citation: Demortiere S et al. Mult Scler. 2020 Mar 23. doi: 10.1177/1352458520912637.

Key clinical point: Patients with multiple sclerosis (MS), particularly those with relapsing-remitting MS (RRMS) have higher serum levels of homocysteine (Hcy). 

Major finding: The MS group had higher serum levels of Hcy (standardized mean difference [SMD], 0.64; P less than .0001) compared with the control group. There were no significant differences in levels of vitamin B12 (SMD, –0.08; P = .58) or folate (SMD, 0.07; P = .52) between the MS and control groups. There was a statistically significant difference for Hcy between patients with RRMS and control individuals (SMD, 0.67; P = .004) but not between patients with primary or secondary progressive MS and control individuals.

Study details: A meta-analysis of 21 studies, including 1,738 patients with MS and 1,424 control individuals.

Disclosures: The study was supported by the National Natural Science Foundation of China and the Beijing Municipal Administration of Hospitals Incubating Program. The authors declared no conflicts of interest. 

Citation: Li X et al. Int J Med Sci. 2020 Mar 5. doi: 10.7150/ijms.42058.

Key clinical point: Patients with multiple sclerosis (MS), particularly those with relapsing-remitting MS (RRMS) have higher serum levels of homocysteine (Hcy). 

Major finding: The MS group had higher serum levels of Hcy (standardized mean difference [SMD], 0.64; P less than .0001) compared with the control group. There were no significant differences in levels of vitamin B12 (SMD, –0.08; P = .58) or folate (SMD, 0.07; P = .52) between the MS and control groups. There was a statistically significant difference for Hcy between patients with RRMS and control individuals (SMD, 0.67; P = .004) but not between patients with primary or secondary progressive MS and control individuals.

Study details: A meta-analysis of 21 studies, including 1,738 patients with MS and 1,424 control individuals.

Disclosures: The study was supported by the National Natural Science Foundation of China and the Beijing Municipal Administration of Hospitals Incubating Program. The authors declared no conflicts of interest. 

Citation: Li X et al. Int J Med Sci. 2020 Mar 5. doi: 10.7150/ijms.42058.

Key clinical point: Patients with multiple sclerosis (MS), particularly those with relapsing-remitting MS (RRMS) have higher serum levels of homocysteine (Hcy). 

Major finding: The MS group had higher serum levels of Hcy (standardized mean difference [SMD], 0.64; P less than .0001) compared with the control group. There were no significant differences in levels of vitamin B12 (SMD, –0.08; P = .58) or folate (SMD, 0.07; P = .52) between the MS and control groups. There was a statistically significant difference for Hcy between patients with RRMS and control individuals (SMD, 0.67; P = .004) but not between patients with primary or secondary progressive MS and control individuals.

Study details: A meta-analysis of 21 studies, including 1,738 patients with MS and 1,424 control individuals.

Disclosures: The study was supported by the National Natural Science Foundation of China and the Beijing Municipal Administration of Hospitals Incubating Program. The authors declared no conflicts of interest. 

Citation: Li X et al. Int J Med Sci. 2020 Mar 5. doi: 10.7150/ijms.42058.

Key clinical point: Cancer risks with natalizumab and rituximab in patients with multiple sclerosis (MS) are similar to the general population, whereas there is a possible modest increase in risk with fingolimod.

Major finding: Adjusting for demography, previous cancer, and comorbidities, the risk of invasive cancer was similar or slightly lower for natalizumab (hazard ratio [HR], 1.01; 95% CI, 0.57-1.77) and rituximab (HR, 0.85; 95% CI, 0.54-1.32) compared with the general population. There was a possibly higher risk for fingolimod compared with the general population (HR, 1.53; 95% CI, 0.98-2.38) and rituximab (HR, 1.68; 95% CI, 1.00-2.84).

Study details: A Swedish register-based cohort study included 6,136 patients with MS and 37,801 non-MS individuals from the general population.

Disclosures: The study was funded through a Patient-Centered Outcomes Research Institute award. Johan Askling, Anna Fogdell-Hahn, Jan Hillert, Jan Lycke, Petra Nilsson, Magnus Vrethem, Tomas Olsson and Fredrik Piehl reported ties with one or more pharmaceutical companies. The remaining authors declared no conflicts of interest. 

Citation: Alping P et al. Ann Neurol. 2020 Feb 13. doi: 10.1002/ana.25701.

Key clinical point: Cancer risks with natalizumab and rituximab in patients with multiple sclerosis (MS) are similar to the general population, whereas there is a possible modest increase in risk with fingolimod.

Major finding: Adjusting for demography, previous cancer, and comorbidities, the risk of invasive cancer was similar or slightly lower for natalizumab (hazard ratio [HR], 1.01; 95% CI, 0.57-1.77) and rituximab (HR, 0.85; 95% CI, 0.54-1.32) compared with the general population. There was a possibly higher risk for fingolimod compared with the general population (HR, 1.53; 95% CI, 0.98-2.38) and rituximab (HR, 1.68; 95% CI, 1.00-2.84).

Study details: A Swedish register-based cohort study included 6,136 patients with MS and 37,801 non-MS individuals from the general population.

Disclosures: The study was funded through a Patient-Centered Outcomes Research Institute award. Johan Askling, Anna Fogdell-Hahn, Jan Hillert, Jan Lycke, Petra Nilsson, Magnus Vrethem, Tomas Olsson and Fredrik Piehl reported ties with one or more pharmaceutical companies. The remaining authors declared no conflicts of interest. 

Citation: Alping P et al. Ann Neurol. 2020 Feb 13. doi: 10.1002/ana.25701.

Key clinical point: Cancer risks with natalizumab and rituximab in patients with multiple sclerosis (MS) are similar to the general population, whereas there is a possible modest increase in risk with fingolimod.

Major finding: Adjusting for demography, previous cancer, and comorbidities, the risk of invasive cancer was similar or slightly lower for natalizumab (hazard ratio [HR], 1.01; 95% CI, 0.57-1.77) and rituximab (HR, 0.85; 95% CI, 0.54-1.32) compared with the general population. There was a possibly higher risk for fingolimod compared with the general population (HR, 1.53; 95% CI, 0.98-2.38) and rituximab (HR, 1.68; 95% CI, 1.00-2.84).

Study details: A Swedish register-based cohort study included 6,136 patients with MS and 37,801 non-MS individuals from the general population.

Disclosures: The study was funded through a Patient-Centered Outcomes Research Institute award. Johan Askling, Anna Fogdell-Hahn, Jan Hillert, Jan Lycke, Petra Nilsson, Magnus Vrethem, Tomas Olsson and Fredrik Piehl reported ties with one or more pharmaceutical companies. The remaining authors declared no conflicts of interest. 

Citation: Alping P et al. Ann Neurol. 2020 Feb 13. doi: 10.1002/ana.25701.

Key clinical point: Although injectables are the most frequently used disease-modifying agents (DMAs) for multiple sclerosis (MS), the utilization of oral DMAs is increasing.

Major finding: Between 2006 and 2015, DMAs were prescribed in 45% of MS visits. Although injectables remain the most commonly prescribed DMAs (78%), the use of oral DMAs has increased (from 11% in 2010-2011 to 40% in 2014-2015) and that of injectable DMAs has decreased (from 96% in 2006-2007 to 52% in 2014-2015). Visiting a neurologist was the strongest predictor of DMA use (odds ratio, 6.61; 95% CI, 3.66-11.93). 

Study details: A cross-sectional study examined the prescribing patterns and trends of DMAs in the US using the 2006-2015 National Ambulatory Medical Care Survey.

Disclosures: The study was not funded. George Hutton and Rajender Aparasu reported receiving grants from multiple pharmaceutical companies outside the submitted work. The remaining authors declared no conflicts of interest. 

Citation: Earla JR et al. Res Social Adm Pharm. 2020 Mar 11. doi: 10.1016/j.sapharm.2020.02.016. 

Key clinical point: Although injectables are the most frequently used disease-modifying agents (DMAs) for multiple sclerosis (MS), the utilization of oral DMAs is increasing.

Major finding: Between 2006 and 2015, DMAs were prescribed in 45% of MS visits. Although injectables remain the most commonly prescribed DMAs (78%), the use of oral DMAs has increased (from 11% in 2010-2011 to 40% in 2014-2015) and that of injectable DMAs has decreased (from 96% in 2006-2007 to 52% in 2014-2015). Visiting a neurologist was the strongest predictor of DMA use (odds ratio, 6.61; 95% CI, 3.66-11.93). 

Study details: A cross-sectional study examined the prescribing patterns and trends of DMAs in the US using the 2006-2015 National Ambulatory Medical Care Survey.

Disclosures: The study was not funded. George Hutton and Rajender Aparasu reported receiving grants from multiple pharmaceutical companies outside the submitted work. The remaining authors declared no conflicts of interest. 

Citation: Earla JR et al. Res Social Adm Pharm. 2020 Mar 11. doi: 10.1016/j.sapharm.2020.02.016. 

Key clinical point: Although injectables are the most frequently used disease-modifying agents (DMAs) for multiple sclerosis (MS), the utilization of oral DMAs is increasing.

Major finding: Between 2006 and 2015, DMAs were prescribed in 45% of MS visits. Although injectables remain the most commonly prescribed DMAs (78%), the use of oral DMAs has increased (from 11% in 2010-2011 to 40% in 2014-2015) and that of injectable DMAs has decreased (from 96% in 2006-2007 to 52% in 2014-2015). Visiting a neurologist was the strongest predictor of DMA use (odds ratio, 6.61; 95% CI, 3.66-11.93). 

Study details: A cross-sectional study examined the prescribing patterns and trends of DMAs in the US using the 2006-2015 National Ambulatory Medical Care Survey.

Disclosures: The study was not funded. George Hutton and Rajender Aparasu reported receiving grants from multiple pharmaceutical companies outside the submitted work. The remaining authors declared no conflicts of interest. 

Citation: Earla JR et al. Res Social Adm Pharm. 2020 Mar 11. doi: 10.1016/j.sapharm.2020.02.016. 

Key clinical point: In patients with multiple sclerosis (MS), N-acetyl cysteine (NAC) positively affects cerebral glucose metabolism, and this appears to be associated with improved symptoms related to cognition and attention.

Major finding: Based on fluorodeoxyglucose (FDG) positron emission tomography (PET) data, NAC group vs. the control group demonstrated significant increases in cerebral glucose metabolism after therapy in several brain regions including the lateral and middle temporal lobes, inferior frontal lobe, and caudate (P less than .05). NAC group had significant improvements in self-reported scores related to cognition and attention.

Study details: Twenty-four patients with a diagnosis of MS were randomly assigned to NAC plus standard of care or standard of care only (waitlist control group). FDG PET was used to assess cerebral glucose metabolism at baseline and after 2 months in all patients.

Disclosures: This study was supported by a grant from the Coors Foundation. The authors declared no potential conflicts of interest.

Citation: Monti DA et al. Front Neurol. 2020 Feb 14. doi: 10.3389/fneur.2020.00088.

Key clinical point: In patients with multiple sclerosis (MS), N-acetyl cysteine (NAC) positively affects cerebral glucose metabolism, and this appears to be associated with improved symptoms related to cognition and attention.

Major finding: Based on fluorodeoxyglucose (FDG) positron emission tomography (PET) data, NAC group vs. the control group demonstrated significant increases in cerebral glucose metabolism after therapy in several brain regions including the lateral and middle temporal lobes, inferior frontal lobe, and caudate (P less than .05). NAC group had significant improvements in self-reported scores related to cognition and attention.

Study details: Twenty-four patients with a diagnosis of MS were randomly assigned to NAC plus standard of care or standard of care only (waitlist control group). FDG PET was used to assess cerebral glucose metabolism at baseline and after 2 months in all patients.

Disclosures: This study was supported by a grant from the Coors Foundation. The authors declared no potential conflicts of interest.

Citation: Monti DA et al. Front Neurol. 2020 Feb 14. doi: 10.3389/fneur.2020.00088.

Key clinical point: In patients with multiple sclerosis (MS), N-acetyl cysteine (NAC) positively affects cerebral glucose metabolism, and this appears to be associated with improved symptoms related to cognition and attention.

Major finding: Based on fluorodeoxyglucose (FDG) positron emission tomography (PET) data, NAC group vs. the control group demonstrated significant increases in cerebral glucose metabolism after therapy in several brain regions including the lateral and middle temporal lobes, inferior frontal lobe, and caudate (P less than .05). NAC group had significant improvements in self-reported scores related to cognition and attention.

Study details: Twenty-four patients with a diagnosis of MS were randomly assigned to NAC plus standard of care or standard of care only (waitlist control group). FDG PET was used to assess cerebral glucose metabolism at baseline and after 2 months in all patients.

Disclosures: This study was supported by a grant from the Coors Foundation. The authors declared no potential conflicts of interest.

Citation: Monti DA et al. Front Neurol. 2020 Feb 14. doi: 10.3389/fneur.2020.00088.

Key clinical point: Diet quality is not associated with the risk for late-onset multiple sclerosis (MS) in middle-aged individuals.

Major finding: Diet quality, assessed by means of the Alternative Healthy Eating Index-2010, was not statistically significantly associated with late-onset MS diagnosis risk (hazard ratio highest vs. lowest tertile, 0.79; test for trend: P = .22). Smoking did not modify the association.

Study details: Prospective cohort study based on the Danish cohort “Diet, Cancer and Health” evaluated the association between diet quality and the hazards of late-onset MS diagnosis in 56,867 individuals (age, 50-64 years) who were followed for a median of 20.4 years; 124 patients with MS were identified.

Disclosures: This study did not receive any specific funding. The data collection for the Diet, Cancer and Health cohort was funded by the Danish Cancer Society. Ulrik Dalgas has received research support, travel grants, and/or teaching honorary from Biogen Idec, Merck Serono, Novartis, Bayer Schering, and Sanofi Aventis as well as honoraria from serving on scientific advisory boards of Biogen Idec and Genzyme. The other authors reported no conflicts of interest.

Citation: Pommerich UM et al. Mult Scler Relat Disord. 2020 Jan 26. doi: 10.1016/j.msard.2020.101968. 

Key clinical point: Diet quality is not associated with the risk for late-onset multiple sclerosis (MS) in middle-aged individuals.

Major finding: Diet quality, assessed by means of the Alternative Healthy Eating Index-2010, was not statistically significantly associated with late-onset MS diagnosis risk (hazard ratio highest vs. lowest tertile, 0.79; test for trend: P = .22). Smoking did not modify the association.

Study details: Prospective cohort study based on the Danish cohort “Diet, Cancer and Health” evaluated the association between diet quality and the hazards of late-onset MS diagnosis in 56,867 individuals (age, 50-64 years) who were followed for a median of 20.4 years; 124 patients with MS were identified.

Disclosures: This study did not receive any specific funding. The data collection for the Diet, Cancer and Health cohort was funded by the Danish Cancer Society. Ulrik Dalgas has received research support, travel grants, and/or teaching honorary from Biogen Idec, Merck Serono, Novartis, Bayer Schering, and Sanofi Aventis as well as honoraria from serving on scientific advisory boards of Biogen Idec and Genzyme. The other authors reported no conflicts of interest.

Citation: Pommerich UM et al. Mult Scler Relat Disord. 2020 Jan 26. doi: 10.1016/j.msard.2020.101968. 

Key clinical point: Diet quality is not associated with the risk for late-onset multiple sclerosis (MS) in middle-aged individuals.

Major finding: Diet quality, assessed by means of the Alternative Healthy Eating Index-2010, was not statistically significantly associated with late-onset MS diagnosis risk (hazard ratio highest vs. lowest tertile, 0.79; test for trend: P = .22). Smoking did not modify the association.

Study details: Prospective cohort study based on the Danish cohort “Diet, Cancer and Health” evaluated the association between diet quality and the hazards of late-onset MS diagnosis in 56,867 individuals (age, 50-64 years) who were followed for a median of 20.4 years; 124 patients with MS were identified.

Disclosures: This study did not receive any specific funding. The data collection for the Diet, Cancer and Health cohort was funded by the Danish Cancer Society. Ulrik Dalgas has received research support, travel grants, and/or teaching honorary from Biogen Idec, Merck Serono, Novartis, Bayer Schering, and Sanofi Aventis as well as honoraria from serving on scientific advisory boards of Biogen Idec and Genzyme. The other authors reported no conflicts of interest.

Citation: Pommerich UM et al. Mult Scler Relat Disord. 2020 Jan 26. doi: 10.1016/j.msard.2020.101968. 

Key clinical point: Increase in leptin concentration is associated with an elevated multiple sclerosis (MS) risk among young individuals.

Major finding: A 1-unit increase in leptin z-score was associated with higher MS risk in individuals younger than 20 years (odds ratio [OR], 1.4; 95% confidence interval, 1.1-1.9) and in all men (OR, 1.4; 95% confidence interval, 1.0-2.0). In contrast, MS risk reduced with increased leptin levels in women aged 30-39 years after adjustment for insulin levels (OR, 0.74; 95% confidence interval, 0.54-1.0).

Study details: This nested case-control study used blood samples from Swedish biobanks and compared leptin and insulin concentrations in 649 individuals who later developed relapsing-remitting MS and 649 matched controls.

Disclosures: This study was supported by the Swedish Research Council. Lucia Alonso-Magdalena has received speaking fees from Merck Serono and served on advisory board for Merck Serono and Biogen. Magnus Vrethem has received honoraria for lectures from Genzyme and for advisory boards from Roche and Novartis. 

Citation: Biström M et al. Mult Scler. 2020 Feb 7. doi: 10.1177/1352458520905033.

Key clinical point: Increase in leptin concentration is associated with an elevated multiple sclerosis (MS) risk among young individuals.

Major finding: A 1-unit increase in leptin z-score was associated with higher MS risk in individuals younger than 20 years (odds ratio [OR], 1.4; 95% confidence interval, 1.1-1.9) and in all men (OR, 1.4; 95% confidence interval, 1.0-2.0). In contrast, MS risk reduced with increased leptin levels in women aged 30-39 years after adjustment for insulin levels (OR, 0.74; 95% confidence interval, 0.54-1.0).

Study details: This nested case-control study used blood samples from Swedish biobanks and compared leptin and insulin concentrations in 649 individuals who later developed relapsing-remitting MS and 649 matched controls.

Disclosures: This study was supported by the Swedish Research Council. Lucia Alonso-Magdalena has received speaking fees from Merck Serono and served on advisory board for Merck Serono and Biogen. Magnus Vrethem has received honoraria for lectures from Genzyme and for advisory boards from Roche and Novartis. 

Citation: Biström M et al. Mult Scler. 2020 Feb 7. doi: 10.1177/1352458520905033.

Key clinical point: Increase in leptin concentration is associated with an elevated multiple sclerosis (MS) risk among young individuals.

Major finding: A 1-unit increase in leptin z-score was associated with higher MS risk in individuals younger than 20 years (odds ratio [OR], 1.4; 95% confidence interval, 1.1-1.9) and in all men (OR, 1.4; 95% confidence interval, 1.0-2.0). In contrast, MS risk reduced with increased leptin levels in women aged 30-39 years after adjustment for insulin levels (OR, 0.74; 95% confidence interval, 0.54-1.0).

Study details: This nested case-control study used blood samples from Swedish biobanks and compared leptin and insulin concentrations in 649 individuals who later developed relapsing-remitting MS and 649 matched controls.

Disclosures: This study was supported by the Swedish Research Council. Lucia Alonso-Magdalena has received speaking fees from Merck Serono and served on advisory board for Merck Serono and Biogen. Magnus Vrethem has received honoraria for lectures from Genzyme and for advisory boards from Roche and Novartis. 

Citation: Biström M et al. Mult Scler. 2020 Feb 7. doi: 10.1177/1352458520905033.