b'Medicine & Researchsignicantly increased. Reductions in urinaryplacebo was conducted at 116 hospital clinics incontinence as well as bladder capacity andand specialized MS centers in 20 countries. detrusor pressure were improved with eachMasitinib is still under development and has aboBoNT-A dose versus placebo. Symptomaticnot been approved by any health authority urinary tract infection was the most frequentyet. Patients with primary progressive MS or treatment-emergent adverse event. The studiesnonactive secondary progressive MS were were terminated prematurely due to slowtreated for 96 weeks. A total of 611 patients were recruitment and were not designed for statisticalrandomized: 301 in the Masitinib 4.5 mg/kg/d comparison between the two aboBoNT-A doses.parallel group and 310 in the uptitrated This study was published in European Urology.Masitinib 6 mg/kg/d parallel group. The lower Dr. Thrower: Bladder symptoms are frustratinglydose group showed signicant benet over common in MS. They can be embarrassing andplacebo. Efficacy results from the higher dose lead to changes in quality of life and activitiesparallel group were inconclusive, and no new of daily living. Please be sure to discuss anysafety signal was observed. The average bladder symptoms you have with your healthcarepatient age was 50 years old and patients team; treatment options are available. With MS,with PPMS accounted for 40 percent and 45 the bladder can act up in a few ways. Somepercent of the participants, in the respective people have a small, overactive bladder, whichgroups. Adverseeventsincludedknown can lead to urinary urgency, frequency, andside-effects of Masitinib such as diarrhea, rash, incontinence. Some people deal with a large,nausea, etc. Relapses were reported by 7.5 underactive bladder with urinary retention,percent for those taking the medication and which can lead to some spasms causing6.9 percent for the placebo. More research is urgency and frequency. UTIs and even kidneyneededtoconrmitsbenetsofslowing damage can result from the retention. SomeEDSS. This study was published in Neurology people experience bladder dyssynergia, this isNeuroimmunology & Neuroinammation. when the bladder muscle is squeezing, but theDr. Thrower:Researchhasmadegreat valve/sphincter to let urine out is not opening. advances in MS therapeutics, but most of our The small, overactive bladder can begains have been for relapsing forms of MS. managed with various medications. When thoseProgressive MS remains a challenge. Anytime drugs are not effective or cause unacceptableI see studies focusing on progressive forms side effects, botulinum toxin injections into theof MS, I pay attention and our center seeks bladder muscle may be an option. Botulinumthose studies out. Masitinib is an oral agent toxin can be injected into the bladder musclethat works by inhibiting tyrosine kinase. TK by an urologist to help calm an overactiveplays a role in multiple cell functions including bladder. how long the cells live. Progressive forms Masitinib shows promiseof MS tend to be more degenerative than for treating progressive MSinammatory. This may be why our therapies that target inammation are not as effective A randomized, double-blind, two parallel- in progressive forms of MS. Masitinib may group, placebo-controlled trial assessing twoprovide an answer. The drug is also being dose levels of Masitinib versus equivalentstudied in ALS, a purely neurodegenerative msfocusmagazine.org 58'