53 msfocusmagazine.org about disease-modifying treatment, and secondly in people who have been treated with Alemtuzumab, to ensure the risks associated with dangerous side effects are minimized. The results were published in JAMA Neurology. Dr. Thrower: With the recent approval of ocrelizumab, we now have 16 treatment options to help change the course of MS. Every option can essentially be given a score card based upon convenience, safety, and effectiveness. Most would agree that alemtuzumab (Lemtrada) is one of the most effective therapies available for RRMS. Safety has been a concern, however. The use of alemtuzumab does require regular laboratory monitoring for four years after a round of treatment. Fortunately, the manufacturer has gone to great lengths to make this as easy as possible for both the person with MS and the healthcare team. One of the safety concerns with this drug has been the risk of B-cell-driven autoimmune diseases, like thyroid disease and low platelet counts. Alemtuzumab reduces the numbers of bothT- and B-cells,with the lattersometimes coming back with a vengeance. This may be the cause for the secondary autoimmune side effects seen in some after alemtuzumab treatment. There is currently a lot of interest in B-cell therapies for MS, with ocrelizumab being one. Could we potentially follow a course of alemtuzumab with a low dose of ocrelizumab to reduce the risk of the B-cell rebound from the former? Would it be safe? Stay tuned. Acne medication possible new MS treatment A Canadian clinical trial shows that a common acne medication may slow the progress of relapsing-remitting multiple sclerosis in people who have recently experienced their first symptoms. The discoveryoffers a safe and affordable treatment option for those with early onset MS and could affect thousands of newly diagnosed MS patients around the world. The drug itself, minocycline, has been around for 50 years, and it doesn't need further Health Canada approval to be used as an off-label prescription for MS. The results were published in the New England Journal of Medicine. Dr.Thrower:While science is always searching for new treatments for different health conditions, there is also a large effort to repurpose old drugs for new purposes. Such is the case with minocycline. Minocycline is an old antibiotic in the tetracycline family. It is most commonly used to treat acne. The drug is inexpensive and has a good safety profile. While its antibiotic properties are well known, more recently, the drug has been found to have anti-inflammatory and neuro- protective effects. This study with minocycline looked at individuals with the first demyelinating event or clinically isolated syndrome. During six months, minocycline reduced the likelihood of having a second attack by 27.6 percent compared to placebo. Years ago, similar studies showed a 45 percent reduction in the risk of a second attack with Copaxone and a 44 percent reduction with Avonex Misbehaving mitochondria may play MS role An international team, including both the University of Exeter Medical School and the University of Alberta, has discovered a new