USF Multiple Sclerosis Center part of new therapeutic landscape for patients
The same day that the University of South Florida celebrated the 20th anniversary of its USF Multiple Sclerosis Center, the U.S. Food and Drug Administration approved a new oral therapy (Aubagio) for multiple sclerosis, a neurodegenerative autoimmune disease.
The news reinforces what Center Director Dr. Stanley Krolczyk says about how recent advances in “disease-modifying” drugs are helping to reduce the frequency and severity of MS relapses and slow the rate of disease progression.
Until recently patients diagnosed with MS typically had to turn to injectable drugs like beta interferons for chronic treatment, while infusions of high-dose steroids are mainly used to treat exacerbations of the disease. While these treatments can help alleviate symptoms, they do little or nothing to alter the course of the disease or delay disability.
Aubagio is the second oral MS medication to enter the market (following the first FDA-approved MS pill Gilenya in 2010), with more disease-modifying prospects expected in the near future.
“Before 1993 there were no treatments for MS,” said Dr. Krolczyk, associate professor and director of the Multiple Sclerosis Division in the USF Health Department of Neurology. “It’s great that we can now offer our patients more treatment choices than ever before to help improve the quality of their lives.”
MS is the most common disabling neurological disease among young adults, affecting about 400,000 Americans, according to the National Institute of Neurological Disorders and Stroke. Caused by damage to the myelin sheath – the protective coating of nerves in the brain and spinal cord – MS can trigger a broad spectrum of symptoms, including fatigue, pain, numbness, muscle spasms, vision loss, problems with balance and other difficulties. The disease – afflicting twice as many women as men — is usually diagnosed between the ages of 20 and 50, and often gradually worsens over time.
MS is still incurable, but the rapid pace at which investigational treatments have moved from clinical trials to market over the last decade encourages patients like Jzon Livingston, Sr., of Clearwater.
Livingston, 33, has relapsing-remitting MS, the most common form of the disease, which is characterized by attacks lasting from days to weeks followed by remission, or periods of little or no symptoms. Diagnosed in 2008, he participates in an ongoing clinical trial for a promising once-a-year infusion therapy for MS (alemtuzumab), a monoclonal antibody designed to target certain cells in the immune system believed to trigger damage in people with MS.
None of the standard MS treatments worked for Livingston, and he battled relapses every two to three months. When the attacks flared, he had a hard time dragging himself off the couch to do anything, he said. “It was a fairly miserable existence.”
Since beginning alemtuzumab as a patient at the USF Multiple Sclerosis Center, Livingston said, his life has changed significantly. He experiences few relapses and works as a self-employed IT network administrator, travels, and enjoys spending time with his wife and three sons.While not without side effect risks – alemtuzumab is a cancer drug used by doctors to treat leukemia for decades — the investigational MS regimen “has been effective beyond anything I thought possible,” Livingston said. “At USF, I was able to find a path to treatment unavailable anywhere else I had tried. It’s given me, my family and my entire extended network hope for the future.”
Livingston shared his perspective as an MS patient with those who gathered Thursday evening, Sept. 13th to mark the 20-year anniversary of the USF Multiple Sclerosis Center.
Among the speakers was the center’s founding director Dr. Peter Dunne, who provided an entertaining overview of the MS clinic’s history. The center was opened by Dr. Dunne and nurse practitioner Lisé Casady at Tampa General Hospital in 1993 and moved to the USF Medical Clinic in 2000 before relocating to expanded space in the Morsani Center for Advanced Healthcare in 2008.
While he talked about changes in technology and discoveries that have led to more treatment options, Dr. Dunne emphasized the importance of patients, staff and volunteers in helping build the MS Center.
“Let’s not forget the role people play in this story,” he said. “I think they are all heroes.”
Before retiring, Dr. Dunne tapped Dr. Krolczyk, a new neurology faculty member at USF Health, to serve as the center’s next director. Dr. Clifton Gooch, USF Health chair of neurology, said that Dr. Dunne was instrumental in laying the foundation needed to make the university’s MS center a force in “the therapeutic revolution in neurology,” and Dr. Krolczyk continues to propel the center “to the next level.”
Under Dr. Krolczyk’s tenure, the MS Center has grown to one of the largest comprehensive MS clinics in the Southeast, serving more than 1,500 patients across Central Florida and overseeing 15 active clinical trials, with six studies currently recruiting patients.
The center focuses on early diagnosis and chronic treatment of MS, while offering eligible patients an opportunity to join clinical studies of potential new treatments years before they may become commercially available.
Because MS is a disease that can impair movement, sensation and thinking, its management requires multidisciplinary expertise. The center’s team includes physicians, a physician’s assistant, nurse practitioner, research coordinator, and neuropsychologist, and patients have ready access to urological care, physical therapy and neuropsychiatric evaluation.
Through USF’s partnership with the mid-Florida Chapter of the National Multiple Sclerosis Society, center patients benefit from educational resources and consultations with the local chapter’s staff.The center actively pursues new avenues for MS therapies, Dr. Krolczyk said, including the identification of biomarkers that may lead to earlier diagnosis and more effective treatments based on an individual’s genetic profile.
In addition to news about new treatments on the horizon, MS has attracted more national exposure lately with mentions by high-profile people like Ann Romney, wife of presidential candidate Mitt Romney, and First Lady Michelle Obama. Romney has spoken publicly about her diagnosis with MS in 1998, including last month at the Republican National Convention in Tampa. Obama shared her father’s 30-year struggle with the disease a week later at the Democratic National Convention in Charlotte, NC.
“There’s a positive impact when patients see someone at the podium like Ann Romney who lives with MS, but has successfully managed a full schedule,” Dr. Krolczyk said. “It puts a different face on the disease.”
Dr. Krolczyk remains optimistic about the future of MS research given the remarkable advances in MS treatment over the last 20 years.
“Today MS does not have to take control of patients,” he said. “They have options to take control of MS.”
For more information about the USF Multiple Sclerosis, visit http://health.usf.edu/medicine/neurology/clinicalprograms/multiple_sclerosis.htm
Photos by Eric Younghans, USF Health Communications