Clinical Trial MS Drug Pipe 307: Potential Remyelination Drug

Join me to discuss a specific MS drug shown in research thus far to help with remyelination! Do you remember that there was research in the MS world that looked at the possible effects of clemastine on MS? That same research has been integral in helping researchers develop an even more effective drug currently in phase two trials, and it’s showing promising results for remyelination in humans!

New Data from 46,000 People with Multiple Sclerosis Explained by Neurologist

In this study, I review data from an article that examines 61 randomized trials involving 46,611 participants. The focus is on identifying the predictors of who is more likely to experience relapses and new MRI lesions. I also explore which individuals benefit the most from medications and discuss the associated risks.

Earlier diabetes diagnosis linked to dementia risk

Adults diagnosed with type 2 diabetes in mid-life—before age 50—more likely to develop dementia
Adults diagnosed with type 2 diabetes in mid-life—before age 50—are more likely to develop dementia.

Individuals diagnosed with type 2 diabetes at a younger age face a greater risk of developing dementia compared to those diagnosed later in life, according to research conducted by experts at the NYU Rory Meyers College of Nursing.

“Our study indicates that early-onset type 2 diabetes may have cognitive consequences. It highlights the need for prevention strategies for dementia that take both diabetes and obesity into account,” said Xiang Qi, assistant professor at NYU Meyers and the study’s lead author.

Type 2 diabetes is a recognized risk factor for dementia. While the exact mechanisms behind this connection are not completely understood, researchers believe that certain characteristics of diabetes—such as high blood sugar levels, insulin resistance, and inflammation—may contribute to the onset of dementia in the brain.

Type 2 diabetes, once common among older adults, is now increasingly seen in younger individuals. Currently, one in five people with type 2 diabetes globally is under 40 years old.

To investigate how the timing of a type 2 diabetes diagnosis is associated with the risk of developing dementia, a research team analyzed data from the Health and Retirement Study, conducted by the University of Michigan Institute for Social Research. The study, published in PLOS ONE, included 1,213 U.S. adults aged 50 and older who had type 2 diabetes confirmed by blood tests and did not have dementia when they entered the study. The participants were followed for up to 14 years, during which 216 individuals (17.8%) developed dementia, as determined by follow-up telephone interviews.

The researchers found that adults diagnosed with type 2 diabetes at younger ages were at increased risk for developing dementia compared to those diagnosed at 70 years or older. Adults diagnosed with diabetes before age 50 were 1.9 times as likely to develop dementia as those diagnosed at 70 and older, while those diagnosed between 50-59 years were 1.72 times as likely and those diagnosed between 60-69 years were 1.7 times as likely.

Using linear trend tests, the researchers found a graded association between age at diagnosis and dementia risk: for each year younger a person is at the time of their type 2 diabetes diagnosis, their risk for developing dementia increases by 1.9%.

“While we do not know for sure why an earlier diabetes diagnosis would increase the risk for dementia, prior studies show that people diagnosed with type 2 diabetes in mid-life may experience more vascular complications, poor blood sugar control, and insulin resistance—all of which are known risk factors for cognitive impairment,” said Bei Wu, the Dean’s Professor in Global Health and vice dean for research at NYU Meyers and the study’s senior author.

In addition, obesity appeared to influence the relationship between type 2 diabetes and dementia. Individuals with obesity who were diagnosed with type 2 diabetes before age 50 had the highest dementia risk in the study.

The researchers note that this greater understanding of the connection between diabetes onset, obesity, and dementia may help inform targeted interventions to prevent dementia.

“Our study highlights the importance of one’s age at diabetes diagnosis and suggests that specifically targeting obesity—whether through diet and exercise or perhaps medication—may play a role in staving off dementia in younger adults with diabetes,” said Wu.

Multiple sclerosis drug may help with poor working memory

A USC study of prescription data shows that people with Medicaid or Medicare Part D may be missing out on powerful new obesity and diabetes drugs

Fampridine is currently used to improve walking ability in individuals with multiple sclerosis. A new study indicates that it may also assist people with reduced working memory, which is often observed in mental health conditions like schizophrenia or depression.

Working memory is essential for everyday tasks, such as remembering a code long enough to type it in and engaging in conversations by reacting appropriately to what others say. It allows us to retain information for a brief period actively, typically a few seconds. However, certain conditions, including schizophrenia, depression, and ADHD, can impair working memory. Individuals affected by these conditions may struggle to follow conversations and to organize their thoughts effectively.

Fampridine is a drug that could help in such cases, as researchers led by Professor Andreas Papassotiropoulos and Professor Dominique de Quervain at the University of Basel have shown.

Practical only if working memory is poor

In their study, the researchers tested the effectiveness of fampridine on working memory in 43 healthy adults. Fampridine showed a more pronounced effect in participants whose baseline working memory was low. After taking the active substance for three days, they scored better in the relevant tests than those who took the placebo. In contrast, the drug showed no effect in people with good baseline working memory.

The researchers also observed that fampridine increased brain excitability in all participants, thus enabling faster processing of stimuli. The study was randomized and double-blind.

The established drug, a new application

“Fampridine doesn’t improve everyone’s working memory. But it could be a treatment option for those with reduced working memory,” explains Andreas Papassotiropoulos. Dominique de Quervain adds: “That’s why, together with researchers from the University Psychiatric Clinics Basel (UPK), we’re planning studies to test the efficacy of fampridine in schizophrenia and depression.”

The drug is currently used to improve walking ability in multiple sclerosis (MS). Particularly in capsule form, which releases the active ingredient slowly in the body, fampridine has shown effects on cognitive performance in MS patients. For some, it alleviates the mental fatigue that can accompany MS.

The researchers did not select the drug at random. This study followed comprehensive analyses of genome data to find starting points for repurposing established drugs. Fampridine acts on specific ion channels in nerve cells that, according to the researchers’ analyses, also play a role in mental disorders such as schizophrenia.

Going vegan will save more than $650 a year in grocery costs.

According to new research, a low-fat vegan diet cuts food costs by 19%, or $1.80 per day, compared with a standard American diet that includes meat, dairy, and other animal products. The study also found that a Mediterranean diet costs 60 cents more per day. Total food costs on a vegan diet were 25% lower, $2.40 per day, compared with the Mediterranean diet.

“As grocery prices remain quite high, consumers might consider replacing meat and dairy products with a low-fat vegan diet of fruits, vegetables, grains, and beans. This change could potentially save more than $650 a year on grocery expenses compared to a standard American diet and over $870 compared to the Mediterranean diet,” says Hana Kahleova, MD, PhD, the lead author of the study and director of clinical research at the Physicians Committee for Responsible Medicine. “Adopting a vegan diet can not only lead to financial savings but also improve health by reducing the risk or severity of conditions such as obesity, type 2 diabetes, and heart disease.”

The decrease in costs on the vegan diet was mainly attributable to savings of $2.90 per day on meat, 50 cents per day on dairy products, and 50 cents per day on added fats. These savings outweighed the increased spending of 50 cents per day on vegetables, 30 cents per day on grains, and 50 cents on meat alternatives on the vegan diet.

The new research is a secondary analysis of a previous study by the Physicians Committee, which compared a low-fat vegan diet to a Mediterranean diet. In this study, participants were randomly assigned to follow either a low-fat vegan diet—which included fruits, vegetables, grains, and beans—or a Mediterranean diet, which emphasized fruits, vegetables, legumes, fish, low-fat dairy, and extra-virgin olive oil, for 16 weeks. There were no calorie restrictions for either group. After this phase, participants returned to their baseline diets for a four-week washout before switching to another diet for 16 weeks. The findings showed that the low-fat vegan diet resulted in better outcomes for weight, body composition, insulin sensitivity, and cholesterol levels compared to the Mediterranean diet.

For the food cost assessment, intakes from the study participants’ dietary records were linked to the U.S. Department of Agriculture Thrifty Food Plan, 2021, a database of national food prices, which are calculated from data collected for the consumer price index. The reduction in costs associated with a vegan diet primarily resulted from savings of $2.90 per day on meat, $0.50 per day on dairy products, and $0.50 per day on added fats. These savings exceeded the additional expenses of $0.50 per day on vegetables, $0.30 per day on grains, and $0.50 per day on meat alternatives. Overall, the vegan diet proved to be more economical.