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July 2008 Off the Wire . . .



News Article 01raw

New drug offers hope for severe MS sufferers

Story Provided by: Daily Herald
Article Date: 28 Jul 2008

Every day, Bloomingdale resident Erin Zwirlein grabs a cane and goes for a one-mile walk.

She returns to her townhouse tired, a bit unsteady, but happier than she ever thought possible.

Zwirlein, 36, has the worst kind of multiple sclerosis: the "secondary-progressive" type, defined by a steady and relentless worsening of the disease without any periods of improvement.

As recently as last year, the disease wouldn't let her complete a one-mile walk. Even a shorter one could leave her too tired to stand up.

The difference between then and now is that today, Zwirlein is a participant in a clinical trial of a new drug that doctors hope will be the first to offer viable relief to people with her type of MS.

"I feel so good," she said. "It's like I'm getting my life back."

Zwirlein doesn't know for sure that she's actually getting the drug; half of the 510 patients in the trial get the drug and the other half, a placebo. But she feels good about her chances.

"I'm a positive person," she said. "But I don't think my brain could make these improvements happen on its own."

Dr. Daniel Wynn, the Northbrook physician who invited Zwirlein to participate in the trial, said the drug is one of the most exciting developments he's seen in his 30 years of involvement with MS research.

Up to now, the only existing treatment for secondary-progressive MS is a chemotherapy agent that has limited use because of its toxic effects on the heart. In earlier trials, the only side effect that the new drug has caused is a harmless and temporary flushing of the skin, he said.

"This could be a gigantic advance," Wynn said. "To have something that will help those with the worst form of a terrible disease is a very big deal."

First symptoms

MS remains a mysterious disease, even though roughly 200 people are diagnosed with it each week. Medical experts believe that in MS patients, the body's immune system inappropriately attacks the healthy tissue that coats nerves in the brain and spinal column. The result is an unpredictable, wide-ranging array of symptoms that includes abnormal fatigue, tremors, vision problems and muscle failure. There still is no cure for the disease.

Zwirlein's symptoms first appeared in 1999, when she lived in Wisconsin with her husband and infant daughter.

She experienced bouts of disorienting vertigo. She had trouble keeping her balance. And in a particularly frightening instance, she dropped her baby.

"My arms just gave out," she said. "It was like I didn't have any control. I knew that wasn't normal."

When the diagnosis came, it hit Zwirlein hard. She fell into a near-depression, wondering if her life was coming to an end.

"I went through a period where I'd just start bawling," she said. "It was very bad."

Soon, though, Zwirlein realized she had a choice: Let the disease take over her life, or fight. She decided to fight.

"I'm not the type to just do nothing," Zwirlein said.

So she worked with her doctors on a drug treatment plan. Like most people with MS, Zwirlein was initially diagnosed with the "relapse-remitting" form, in which MS "flare-ups" alternate with periods of recovery. The FDA has approved a number of drugs that can slow the frequency and intensity of attacks in people with this type of the disease.

While undergoing treatment, Zwirlein stayed active. She went back to work, taking a job as a welder in a factory. And she wouldn't let anyone feel sorry for her.

"It might have been a pride thing, but I didn't want anyone to treat me special," she said. "We had a scooter in our garage, but I refused to use it. During a trip to Ireland, I refused to get in a wheelchair, no matter how tired I got. I wanted to show everyone that I was still alive, even though I had this disease."

Zwirlein's fight hit a roadblock when her marriage began to crumble. In 2004, she left her husband and brought her daughter, Morgan, with her to Bloomingdale. The move put her six hours away from her doctors, left her without a job and sparked a stressful custody battle with her husband.

At the same time, Zwirlein's symptoms worsened. The leg brace she'd been wearing for support was no longer enough; she often had to use a cane when she walked. Occasionally, Zwirlein became so weak that she could move only by crawling on the floor.

Searching for a doctor close to home, Zwirlein discovered Wynn's medical office, Consultants in Neurology. She underwent a screening, which revealed some bad news: The disease had advanced to the secondary-progressive stage.

Still, Zwirlein didn't give up hope. She wasn't about to let the disease ruin the new life she was trying to create for herself and Morgan. When Wynn told her about the clinical trial, she jumped at the chance.

"I told Dr. Wynn that the one thing I wanted was to run again with my daughter," Zwirlein said. "I would do anything to make that happen. I know that the trial is a roll of the dice, but Morgan's suffered enough through all this. She's probably suffered most of all."

'You can't give up'

The drug being studied in the clinical trial is known as MBP8298. In earlier trials in Canada and Europe, it has shown promise as a treatment for secondary-progressive MS.

"It appears to slow the progression by five years or more," Wynn said. "That would have a huge impact on people with this form of MS. It could mean the difference between using a cane and using a walker. Or using a walker and using a wheelchair."

Wynn said that the drug seems to defuse the immune system's impulse to attack healthy tissue, similar to how allergy medications stop the body from reacting to pollen or ragweed.

It takes just a few minutes to administer the drug via an IV, and it has not produced any serious side effects so far, Wynn said.

The trial is scheduled to last two years, but Wynn hopes the FDA will approve the drug early once results from the Canada and Europe trials are finalized.

Zwirlein reports that since starting the trial in January, she feels stronger and walks better. She still wears a brace, but she sometimes can complete a one-mile walk without the help of a cane.

"I can't quite run with Morgan yet," she said with a laugh. "But I'm getting there."

Zwirlein hopes that her battle with the disease will inspire other MS patients to keep up the fight, even when things look grim. Toward that end, she's written an article for a medical magazine that takes a humorous look at her experiences.

"You can't give up. You have to keep up the drive to make yourself better," she said. "I sometimes feel like God gave this disease to me because other people just couldn't handle it."

Zwirlein misses working, and getting a job remains at the top of her priority list for the future. She knows it will be tough, especially because of persistent misconceptions about her disease.

"It's funny - people think that your brain doesn't work anymore, that you can't do anything, that you won't strive for anything," she said. "I hope I can show people how wrong that is."

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