Abstract Details

Title Identifying Physiological Predictors of the Solumedrol-Resistant Multiple Sclerosis Relapse and its Clinical Repercussions

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-089

Objective

To describe scenarios in which novel blood test biomarkers that can identify Solumedrol-resistant Multiple Sclerosis (MS) relapses in real time are clinically relevant.

Background MS relapses may last variably from days to months and nearly half of all patients suffering a relapse may not fully recover. Accidental anecdotal clinical observations suggested that MS patients may have transient elevations of von Willebrand Factor Antigen (vWF) and Factor VIII activity in their blood during an acute relapse. Furthermore, it was observed that patients with highly abnormally elevated values seem to suffer from Solumedrol-resistant multiple sclerosis relapses and are at high risk for incomplete relapse recovery and subsequent disability accrual with standard of care relapse treatment.

Design/Methods

De-identified individual patient relapse experiences and available laboratory data regarding Factor VIII activity and von Willebrand Factor Antigen (vWF) levels during a patient’s clinical relapse were collected and correlated with the patient’s neurological exam and extent of relapse recovery. Based on these clinical observations, the levels of vWF antigen, Factor VIII antigen, as well as Factor VIII activity were measured using spectrophotometric methods in two experimental allergic encephalomyelitis (EAE) models.

Results Clinical case series data supports a correlation between abnormally elevated vWF antigen and Factor VIII activity levels with Solumedrol clinical resistance in real time during a MS relapse. EAE studies show a characteristic and transient rise in vWF, Factor VIII antigen, and Factor VIII activity blood levels coincident with relapse onset and peak disease, similar to clinical observations.

Conclusions

Our observations and experiments identify potential measurable blood test biomarkers to characterize MS and EAE relapses in real time, and in particular identify a solumedrol-resistant group of relapses that may still respond to prolonged treatment or other therapy considerations to ultimately reduce disability.

Authors/Disclosures
Dolly Roy, MD (Sourabh Roy) PRESENTER	No disclosure on file
Kaibin Shi (Barrow Neurological Institute)	No disclosure on file
Fu-Dong Shi, MD, PhD (St. Joseph's Hospital and Medical Center)	No disclosure on file

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