Now that the dust has settled from last week’s endMS Conference and the country’s top MS researchers have returned home to continue their amazing work, we can reflect back on the week and celebrate the coming together of so many great minds that have embarked on tackling the many unresolved questions about MS. In organizing the endMS Conference, we set out to bring researchers of all levels, at various stages of their careers, together in one room, to forge new collaborations and enrich each other and the field of MS research as a whole. Over the course of the conference, I was able to reconnect with old colleagues, make new friends and learn about all of the exciting developments in MS research that are currently happening across Canada and the rest of the world.
Today marks the first day of the 2016 endMS Conference in Toronto, ON. When I think back to the first conference hosted in 2007 in Banff, Alberta, I am truly amazed at how much this meeting has grown over the years. What began as a forum for trainees to present and gather feedback on their research, has expanded into a well-established scientific meeting that brings together over 200 MS researchers and clinicians from around the world. In fact, the endMS Conference is now the largest scientific conference focused on MS in Canada.
For those of you who are not familiar with the endMS Conference, it’s held every three years in different cities across Canada, and is hosted by the MS Society of Canada, endMS Research & Training Network, and MS Scientific Research Foundation. It’s a week-long meeting wherein researchers and clinicians come together and present the latest research findings, network and collaborate with other professionals in the field. Many great ideas come from face-to-face interactions among researchers, and so the MS Society is proud to be funding a forum that encourages this engagement, as well as provides young researchers the opportunity to form relationships with peers and meet senior MS research experts.
The 2016 endMS Conference program will include scientific presentations on topics such as cognition, progressive MS, repair, and inflammation, as well as poster presentations where researchers can visually display and answer questions about their research. There is also a day dedicated to people affected by MS where they will meet with trainees and exchange perspectives on how to incorporate the personal voice in research.
Last week, I featured a team led by Dr. Ann Yeh from SickKids Hospital who was awarded one of three Hermès Canada | MS Society Wellness Research Innovation Grants to develop a physical activity app for children and adolescents living with MS. In the last part of this series, we’ll set our sights back on Saskatchewan and focus on Dr. Katherine Knox, Associate Professor at the University of Saskatchewan, who is working collaboratively with community innovator Dalene Newton, Director of Brain Health, Rehabilitation, and Interprofessional Practice, at Saskatoon Health Region. Their project is titled “Web-based physiotherapy in moderate to severe MS”.
Meet the Researcher: Katherine Knox
As part of an ongoing series, I will be featuring interviews with the talented researchers and community innovators who were awarded one of three Hermès Canada | MS Society Wellness Research Innovation Grants to give you a glimpse at the amazing personalities and stories behind the research. Last week, I featured one of the teams from Saskatoon who have set out to study the impact of a Pilates program in people living with MS. This week, I’ll be featuring Dr. Ann Yeh, who is an Associate Professor of Paediatrics at University of Toronto and Staff Neurologist at the Hospital for Sick Children, and community innovator Adam McKillop, President and CEO of Kite & Canary, the digital design and development company tasked with developing a physical activity mobile application (app) for children and adolescents living with MS. The study is titled “Development and Usability Testing of the ATOMIC (Active Teens MultIple sClerosis) Mobile App to Increase Physical Activity Levels in Youth with Multiple Sclerosis”
Meet the Researcher: Dr. Ann Yeh
Today, the MS Society announced the three recipients of the Hermès Canada | MS Society Wellness Research Innovation Grant. Each grant recipient will receive $40,000 over one year to embark on a research study that will lead to a better understanding of wellness and how to integrate physical activity and rehabilitation approaches into MS care and lifestyle for people affected by MS. I’m very excited to see these grants out the door as they represent the culmination of more than a year of planning and consultation with the MS community. This included the valuable feedback on wellness priorities gathered through the MS Wellness Survey, the contribution of our community representatives on the independent review panel for the grants, and the ongoing involvement of people affected by MS in each of the projects as a central pillar of their community engagement strategies.
I’m also excited to learn more about the amazing people who have taken the reins on these studies. Each one of them brings to their study their unique expertise in wellness and/or MS, along with deep roots in their local communities, in a perfect mix that makes them well-positioned to tackle gaps in wellness faced by people affected by MS.
In this multi-part series, I will be featuring interviews with each of the researchers and community innovators leading their respective Hermès Canada | MS Society Wellness Research Innovation Grants to give you a glimpse at the amazing personalities and stories behind the research. This week, we’ll focus on Dr. Charity Evans, Professor of Pharmacy at the University of Saskatchewan, and Jana and Jason Danielson, co-owners of multidisciplinary health and wellness studio Lead Integrated Health Therapies, and their study titled “Determining the Impact of a Pilates Program in Multiple Sclerosis”
Meet the Researcher: Charity Evans
It feels like only yesterday that Team Tera Bio Solutions (TBS), a group of creative, young science and engineering students at University of Waterloo, were awarded $15,000 from the MS Society to create a technological concept and develop it into a wellness tool for people living with multiple sclerosis. The blueprint for this tool was borne out of Hack4Health, a “hackathon” based at University of Waterloo in September last year in which teams of students were given 36 caffeine-fueled hours to put their heads together and develop wellness solutions with the potential to improve quality of life for people living with MS or dementia. To guide their thought process, participants of Hack4Health relied on the wellness priorities expressed by the MS community, both through the MS Wellness Survey and through interacting with people living with MS who acted as mentors during the event. Fast forward one year, and Team TBS is a few steps closer to completing the prototype for its wellness concept. So what has Team TBS been working on since their project kicked off earlier this year, and what inspired them to pursue this approach in the first place?
Each year ECTRIMS ends with a bang as late-breaking research news is presented first thing in the morning. Presenters at the late-breaking news session deliver the newest key findings of pivotal studies and clinical trials. At the session, we heard about a new potential biomarker that can help evaluate the success of progressive MS trials, the effectiveness of available MS disease-modifying therapies in the real world, and topline results from clinical trials of emerging progressive MS and symptom management treatments. Read on for highlights from the ECTRIMS late-breaking news session.
While platform presentations tend to get all the glory and attention at scientific conferences, I like to think of poster presentations as the unsung heroes that cover an enormous breadth of topics and give researchers at all stages of their careers an opportunity to showcase their research. This year’s ECTRIMS conference saw a record-breaking 1,985 abstract submissions, the majority of which were poster presentations spanning topics as diverse as immune mechanisms and remyelination, symptom management approaches, imaging techniques, biomarker discovery, and findings from clinical trials, to name a few. In this post, I’d like to highlight just a few of the posters I came across that focused on how factors like diet, physical activity, mood and fatigue can play a role in the lives of people living with MS and allied diseases.
Ever since disease-modifying therapies emerged onto the scene in the mid-1990s, suppression of damaging inflammation and prevention of the entry of harmful immune cells into the central nervous system (CNS) has formed the backbone of MS treatment. In more recent years, the dialogue has shifted to the topic of remyelination – in other words, coercing the body’s innate repair system to rebuild the myelin damaged during MS. This topic continues to be an unmet need in MS and is receiving a lot of attention at this year’s ECTRIMS conference, where the leaders in remyelination research have converged to share their perspectives and latest findings on myelin repair.
This morning at ECTRIMS we heard from several researchers and clinicians about the use of imaging as a tool to predict disease outcomes in MS. Over the last few days we saw results from studies repeatedly demonstrating that imaging is a strong predictor of:
- The development of MS in those who exhibit early signs
- The development of disability (or worsening of disease)
Imaging has been heralded as the strongest predictor of disease outcomes in MS, and longer studies are not able to pinpoint the long term predictive nature of imaging measures.
Dr. Olga Ciccarelli from University College London presented an overview of the different imaging tools and patterns that can predict risk of developing confirmed MS among those with clinically isolated syndrome (CIS). She referenced studies showing that, after a 20 year follow up, those individuals with CIS who had an abnormal MRI (many lesions displayed on scan) had an 82% risk of developing MS, whereas those with a normal MRI had a 21% risk of MS.
She also noted that T2 lesions, which are seen via a specific MRI method that shows tissue damage and inflammation, are a strong prognostic factor, meaning they can predict disease, which was demonstrated in a paper published in 2015 in Brain by Dr. Mar Tintoré from Vall d’Hebron University Hospital in Barcelona, Spain.
Additional studies were presented showing that people with early signs of MS who also exhibited spinal cord lesions were more likely to develop MS. Dr. Ciccarelli published similar work showing that spinal cord lesions and spinal cord atrophy (tissue damage) can predict levels of disability after 5 years in patients with CIS. She is currently working on the longest follow-up study of patients with CIS (30 years), which will reveal the strength of imaging as a predictive tool for MS disease and add to our current knowledge around risk models for MS.
We also heard from Dr. Tintoré who has done significant work on monitoring CIS patients over the long term. She has been leading a large, real-world, prospectively acquired (acquiring data over time) CIS cohort that has enabled her to identify predictors of EDSS changes, treatment responses, and other disease outcomes. She presented data from her cohort study showing that, after 15 years of follow up, those with CIS who had more than 10 lesions observed on their first (baseline) MRI had an 85% risk of MS, compared to 19% for those who had no lesions on their first MRI. She found that a lower proportion of patients developed accumulation of disability after 10 and 15 years, and early treatment appeared to have prevented the buildup if disability.
Dr. Wallace Brownlee, also from University College London, presented his study on the prognostic strength of imaging in terms of predicting a secondary progressive disease course in those with CIS. He initially enrolled 178 patients with CIS, of which 164 were followed up for a total of 15 years. After the 15 year follow up period ended, 57% of patients had relapsing-remitting MS (RRMS), and 15% had secondary progressive MS (SPMS). He noted that those with CIS who had spinal cord and T1 brain lesions had a higher probability of developing SPMS, meaning those imaging markers are strong predictors of transition to SPMS.
As imaging techniques become more refined, and studies better designed and include larger numbers of people to infer more definitive conclusions, clinicians are becoming better equipped to foretell the outcome of one’s MS over the short and long term. This is especially important for those with the earliest signs of MS as deciding the most appropriate treatment course for those individuals can influence how their disease unfolds in the future
Stay turned for most updates from ECTRIMS, and follow me on Twitter where I will posting live from the sessions throughout the day!