TOVAXIN ROLE CALL

A board to discuss Tcelna as a treatment for Multiple Sclerosis
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IHaveMS-com
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Post by IHaveMS-com »

So what this means is if their is no other mechanism that causes ms other than MRTC's and tovaxin gets rid of them all then it's a cure for 50% and they just need to figure out the other 50%.

The scientists believe they can make vaccine for 95% of people with MS (I don't know if that is for all different types or just RRMS). The question is how do they make vaccine for the other 45%. To be in the current trial you had to test positive for MRTCs and be able to make vaccine.

The other 45% failed on one of those 2 counts. I assume that testing positive for MRTCs is greatly effected by the waxing and waning of RRMS and anything someone might have been taking that could mask the MRTCs. I wish I knew all of the tings that can mask MRTCs. If I did, I would make sure I stayed away from them especially when it came time to test for MRTCs and drawing a bag of blood to make vaccine. Curcumin, which is found in the Indian curry spice turmeric, can mask MRTCs.

The rate at which the patients MRTCs expand is the determining factor as to whether or not vaccine could be made for the study. If you have MRTCs that would take 6 months to expand out to the necessary dose level for vaccine, that would not be quick enough to be in the study, but vaccine could still be made for that person.
Best regards, Tim

In 2001, my family helped fund the startup of Opexa. My father served on the Board of Directors of PharmaFrontiers, now Opexa Therapeutics, until the company completed a successful 23-million dollar financing round.
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Post by IHaveMS-com »

So does this mean that there are people in the trial with SPMS and they two have seen good things, MRTC's wiped out and a reduction in EDSS … When you say breaks in the data into RRMS and SPMS what does this mean?
I do not know how many people in my trial had RRMS verses SPMS. The data from the study did not distinguish between the two forms. The overall data showed a reduction in attacks by 92%. Some of that reduction had to come from patients with SPMS. I will paste in the press release below along with the presentation at the international MS meeting.
If all my MRTS's were wiped out would i feel better?
Since the hope for Tovaxin is to stop the attacks and any disease reversal is up to your body, the answer to your question would probably be the same as the answer to this question. If you stopped having attacks today and did not get any worse, would you feel better?

http://findarticles.com/p/articles/mi_m ... _n15656722

PharmaFrontiers Presents Positive Tovaxin™ Research at International Multiple Sclerosis Meeting
Business Wire, Oct 3, 2005
THE WOODLANDS, Texas -- PharmaFrontiers Corp. (OTCBB:PFTR), a company involved in the development and commercialization of cell therapies, presented positive interim research findings of its Phase I/II clinical trials of Tovaxin(TM), a novel T cell therapeutic vaccine for Multiple Sclerosis on Friday, September 30, 2005, at the 21st European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the 10th Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) congress held in Thessaloniki, Greece. The trial results not only indicated that the treatment appeared safe and well tolerated with no dose-limiting toxicities, but that Tovaxin depletes the myelin-peptide reactive T cells that may contribute to the Multiple Sclerosis (MS) disease processes.
Tovaxin is a trivalent formulation of attenuated myelin-peptide reactive T cells (MRTCs), which are derived from peripheral blood and produced ex vivo as myelin basic protein (MBP), proteolipid protein (PLP) and myelin oligodendrocyte glycoprotein (MOG) reactive T cells.
The Tovaxin treatment depleted MRTCs in patients with MS. The patients in the trial also had improvements in the Multiple Sclerosis Impact Scale (MSIS), which measures subjective physical and psychological parameters, and the Kurtzke Expanded Disability Status Scale (EDSS), which is an objective measure of the patient's physical disability.
"Seeing safety, tolerance and early effectiveness data at this stage of development is gratifying. More important is seeing the lowering of the MRTCs and the improvement in the clinical measures that reaffirms our belief that Tovaxin may be the key to treating patients who are in the earlier stages of MS," said David B. McWilliams, chief executive officer of PharmaFrontiers. "Based on mounting evidence from our research and others, we believe that autoimmune mechanisms directed at myelin tissue of the central nervous system may play a major role in causing MS.
"With our clinical development partner, INC Research, Raleigh, NC, we plan to initiate a follow-on Phase IIb clinical study of clinically isolated syndrome and early relapsing-remitting MS patients by the first quarter of 2006 to advance our understanding of this novel T cell therapeutic vaccine for MS," said McWilliams.
MRTCs play a critical role in the pathogenesis of MS. Previous T cell therapy pilot studies used a monovalent formulation of attenuated MRTCs to deplete MBP reactive T cells. Because several myelin antigens are described as potential autoantigens for MS, depletion of MRTCs using a trivalent formulation may have enhanced therapeutic effects.
The dose escalation study was designed for patients with relapsing-remitting or secondary-progressive MS, intolerant of, or having failed, current therapy. Blood was obtained from each patient from which T cells reactive to two peptides each of three proteins (MBP, PLP, and MOG) were expanded ex vivo and prepared as a trivalent formulation of MRTCs. The MRTCs were attenuated by Cesium137 irradiation prior to patients receiving subcutaneous injections of either 6-9 million cells (Dose 1) or 30-45 million cells (Dose 2) at weeks 0, 4, 12 and 20. MRTC frequencies were performed at baseline and weeks 5, 13, 21, 28 and 52. Patients were evaluated for changes in EDSS, MSIS and exacerbations.
"Tovaxin is a patient-specific therapeutic vaccination strategy for MS patients. To formulate Tovaxin T cell vaccine, the patient's own myelin peptide-specific activated T cell lines are harvested and attenuated on the day of vaccine administration," said Jim C. Williams, Ph.D., PharmaFrontiers chief operating officer and co-author of the study who presented at the meeting. "The shelf-life of the final product is approximately three days."
The study's results demonstrated that MRTCs in the peripheral blood were depleted in a dose dependent manner and analyses showed reductions in all three types of MRTCs at all follow-up visits. All patients in the Dose 2 group had a 100% reduction in MRTC counts at the week five follow-up visit. Percentage reductions were greater in the Dose 2 group than in the Dose 1 group at every follow-up visit. Correlation between the reduction in overall MRTC frequencies and the physical component of the MSIS (p=0.0086) was strong. There was a trend to improved EDSS (p=0.0561). The annual relapse rate (ARR) for the patients prior two years before therapy was 1.28 and following therapy the ARR was 0.10 (92 percent reduction) adjusted for the number of months in the study. The treatment appears to be safe and well tolerated with minimal adverse events and no dose-limiting toxicities.
"If myelin autoreactive T cells are the basis for MS, then we now appear to have a precision guided treatment to seek out and selectively suppress these T cells," said Brian D. Loftus, M.D., director of Neurology Research at the Diagnostic Clinic of Houston, principal investigator for PharmaFrontiers' two current Phase I/II clinical trials of Tovaxin, and co-author of the study who also presented at the meeting.

<shortened url>

Therapy - immunomodulation - Part II
Friday, September 30, 2005, 15:30 - 17:00
Autologous T cell therapy in multiple sclerosis: an open-label safety and dose-range study
B. Loftus, M. Montgomery, J. Williams (The Woodlands, USA)

Objective: To evaluate the safety of a trivalent autologous T cell therapy (TCT) (Tovaxin™) and the effective dose to deplete myelin peptide-reactive T cells (MRTCs) in Multiple Sclerosis. Background: MRTCs play a critical role in the pathogenesis of MS. Previous TCT pilot studies used a monovalent formulation of attenuated MRTCs to deplete myelin basic protein (MBP) reactive T cells. Because several myelin antigens are described as potential autoantigens for MS, depletion of MRTCs using a trivalent formulation (TF) may have enhanced therapeutic effects.
Design/Methods: Patients with relapsing remitting- or secondary progressive-MS intolerant of or having failed current therapy donated blood from which T cells reactive to two peptides each of three proteins [MBP, proteolipid protein (PLP) and myelin oligodendrocyte glycoprotein (MOG)] were expanded ex vivo and prepared as a TF of CD4+ and CD8+ MRTCs. The MRTCs were attenuated by Cesium137 irradiation prior to patients receiving subcutaneous injections of either 6-9 million cells (dose 1) or 30-45 million cells (dose 2) at weeks 0, 4, 12 and 20. MRTC frequencies were performed at baseline and weeks 5, 13, 21, 28 and 52. Patients were evaluated for changes in Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS) and exacerbations.
Results: MRTCs in the peripheral blood were depleted in a dose dependent manner and analyses showed reductions in all 3 types of MRTCs at all follow-up visits. All patients in the dose 2 group had a 100% reduction in MRTC counts at the week 5 follow-up visit. Percentage reductions were greater in the dose 2 group than in the dose 1 group at every follow-up visit. Correlation between the reduction in overall MRTC frequencies and the physical component of the MSIS (p=0.0086) was strong. There was a trend to improved EDSS (p=0.0561). One exacerbation was observed in the dose 1 group. The treatment appears to be safe and well tolerated with minimal adverse events and no dose-limiting toxicities.
Conclusion: MRTCs in patients with MS can be depleted by Tovaxin treatment. MSIS and EDSS clinical measures are improved and the treatment appears safe and well tolerated. A Phase IIb double-blind placebo-controlled trial to study the effects of Tovaxin in treatment of early relapsing MS patients is being planned.
Best regards, Tim

In 2001, my family helped fund the startup of Opexa. My father served on the Board of Directors of PharmaFrontiers, now Opexa Therapeutics, until the company completed a successful 23-million dollar financing round.
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Post by robbie »

I thought it was going towards the way of things like Campath but after reading all this it sounds safer and more effective. It sounds great but what will happen to the poor CRAB's. Keep more good news comming..Thanks for all the info..
Had ms for 28 yrs,
8.5 EDSS
SPMS, 54 yrs old
Taking it day by day
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Post by IHaveMS-com »

I thought it was going towards the way of things like Campath but after reading all this it sounds safer and more effective.
Campath like Tysabri is a monoclonal antibody. They essentially keep all WBCs from entering the CNS and especially the blood-brain barrier. Tovaxin is a targeted T-cell elimination vaccines that enables the body to build and maintain a defense system specifically against MRTCs.
Best regards, Tim

In 2001, my family helped fund the startup of Opexa. My father served on the Board of Directors of PharmaFrontiers, now Opexa Therapeutics, until the company completed a successful 23-million dollar financing round.
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Post by IHaveMS-com »

Hi RS-Girl,
I had my blood drawn on March 12th and had my first injection on May 25th. So it took roughly 10 weeks and that is what I was quoted as the time frame that it would be ready. I wonder if fast healing has anything to do with it.
10 to 14 weeks for vaccine produce is the typical. 10 is on the fast side. I believe the ability to have your cells expand quickly in the lab is a plus. It has nothing to do with the body quickly producing MRTCs and causing an attack. The number of MRTCs floating around is controlled by the memory WBCs that produce them and whatever stimulates them to do so.

You have another plus in your ability to heal quickly. There probably is some connection between that and fast growing cells, but one is relative to your body and the other occurs in the lab.
Best regards, Tim

In 2001, my family helped fund the startup of Opexa. My father served on the Board of Directors of PharmaFrontiers, now Opexa Therapeutics, until the company completed a successful 23-million dollar financing round.
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Post by Lyon »

Well Tim, I'm glad we had that line of thundershowers go through. I don't think I've ever seen you write such a flurry, but it was good because I see that you and I share a lot of the same opinions. You just word it better. Try as I might to do otherwise, my posts always sound like I'm making promises as to the effectiveness of Tovaxin.
IHaveMS-com wrote:The rate at which the patients MRTCs expand is the determining factor as to whether or not vaccine could be made for the study. If you have MRTCs that would take 6 months to expand out to the necessary dose level for vaccine, that would not be quick enough to be in the study, but vaccine could still be made for that person.
That's what I was trying to say earlier but wasn't able to put it as well.
Bob

PS..Tim, the post you added isn't the same link I have on the laptop but it does include the same information I was referring to, and you were right about it referring specifically to mrtc reduction
All patients in the Dose 2 group had a 100% reduction in MRTC counts at the week five follow-up visit.
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Post by CureOrBust »

IHaveMS-com wrote:Campath like Tysabri is a monoclonal antibody. They essentially keep all WBCs from entering the CNS and especially the blood-brain barrier.
My understanding of how Campath works is VERY different. Tysabri stops the bad guys from entering the CNS through the BBB, while campath kills all your current immune system (except for the part that makes a new one) and thereby causes a new non auto-reactive immune system from forming (termed "Rebooting" the Immune System). Very different to Tysabri. If anything, Tysabri and FTY720 share methods.
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Post by CureOrBust »

IHaveMS-com wrote:I wish I knew all of the tings that can mask MRTCs. If I did, I would make sure I stayed away from them especially when it came time to test for MRTCs and drawing a bag of blood to make vaccine. Curcumin, which is found in the Indian curry spice turmeric, can mask MRTCs.
I wish I knew all the things that "masked" MRTC's, as I would take them UNLESS I was going for Tovaxin. Assuming that the "masking"may actually be a suppression of MSTC's, if you are not on Tovaxin, this sounds like a good thing. Remember, only a few are actually being given this treatment currently. There are a lot of us who have to find other treatments for now.
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Post by Lyon »

CureOrBust wrote:My understanding of how Campath works is VERY different. Tysabri stops the bad guys from entering the CNS through the BBB, while campath kills all your current immune system (except for the part that makes a new one) and thereby causes a new non auto-reactive immune system from forming (termed "Rebooting" the Immune System). Very different to Tysabri. If anything, Tysabri and FTY720 share methods.
I think you're both right Cure. It seems to me that both drugs used for "rebooting" the immune system were earlier used as immune suppressants...without especially great results.

Why those particular drugs were used at much higher doses to actually kill the immune system, I don't know, but using the same drugs with the rebooting strategy produced vastly better results.

I don't think most people consider the importance of the different treatment strategy in that situation and it's an essential thing to consider.

I know it's all we had for a long time but suppressing the entire immune system long term in order to control one faulty aspect of the immune system is a dead end street. Although temporarily eliminating the immune system in the hopes that it grows back healthy seems horribly risky it at least might offer the means to an end.

Bob
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Post by Lyon »

CureOrBust wrote:I wish I knew all the things that "masked" MRTC's, as I would take them UNLESS I was going for Tovaxin. Assuming that the "masking"may actually be a suppression of MSTC's, if you are not on Tovaxin, this sounds like a good thing.
Hi Cure,
Tim will have to correct me if I'm wrong but I've grown to think that he's using the word "mask" to cover two different situations. One in which certain substances truly mask the mrtc's... they still exist and do their damage but cause Opexa labs not to be able to detect them and also a second situation in which certain substances lower the mrtc's to the point that it makes it hard for Opexa to detect them. Things like steroids and the crabs.

For right or wrong that's my take on the situation!
Bob
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Post by IHaveMS-com »

Hi Bob,
I don't think I've ever seen you write such a flurry
I am not minding posting right now. The posting buzz isn't there. It might come back or that might be a new improvement. It hot and humid today, that is a weather condition I avoid. It heightens all of my symptoms and I feel yucky.

I hope to get out of town around June 11th. I am about done for today. I have one more post after this and then it is movie time.

Hope you had fun at your party. I have always thought your post are excellent. Even though you do not have MS, you are able to relate well to those of us that do have MS.


I just lost power. I see 4 more posts I will comment further on Campath tomorrow.
Best regards, Tim

In 2001, my family helped fund the startup of Opexa. My father served on the Board of Directors of PharmaFrontiers, now Opexa Therapeutics, until the company completed a successful 23-million dollar financing round.
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Post by IHaveMS-com »

Hi Lars,
Do you suppose the time table for "ready vaccine" is really related to cell growth?
Yes, but logistic factor at the lab would also be a factor. How fast your cells expand is number one.
I have to wonder if geographical issues, clinical trial site competency, site importance, site patient numbers or patient preference (for reasons unknown to us) or just plain "life" delays may have some bearing.
If by life delays you mean logistical problems in the lab, that most certainly effects the rate at which the vaccine can be produced. If the site is unable to ship the blood, Opexa sends people to collect it. To be a site, several different review boards must approve the site. No site is more important than another. No matter where it came from, once the blood is in the lab, it must be processed. There is no patient preference. No one gets to go to the front of the line, but if your cells grow quickly, that will indirectly move you to the front of the lines simply because your vaccine will be finished quicker that those cells that expand more slowly.
Best regards, Tim

In 2001, my family helped fund the startup of Opexa. My father served on the Board of Directors of PharmaFrontiers, now Opexa Therapeutics, until the company completed a successful 23-million dollar financing round.
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Post by Lyon »

Hi Tim,
The following is the press release I was referring to which seems to mean that the mid-dose proved 100% effective in the elimination of mrtc's AND 100% reduction in annual relapse rate.
Bob

April 03, 2007 07:00 AM Eastern Daylight Time
Opexa Therapeutics Reports Positive Top-line Data in Phase I/II Dose Escalation Trial with TovaxinTM for Multiple Sclerosis

THE WOODLANDS, Texas--(BUSINESS WIRE)--Opexa Therapeutics, Inc. (NASDAQ: OPXA), a company involved in the development and commercialization of cell therapies, today announced positive top-line data in an open-label Phase I/II dose escalation clinical trial of the investigational T-cell vaccine, Tovaxin™, for multiple sclerosis. In this one-year, 10-subject dose escalation clinical trial, Tovaxin therapy was shown to be safe and effective. The “per-protocol” analysis of Tovaxin therapy achieved a 90% reduction (p = 0.0039) in annualized relapse rate (ARR) in subjects who received one of the three dosage levels; the doses were 6 – 9 x 106, 30 – 45 x 106 or 60 – 90 x 106 attenuated T-cells. Subjects in the study received subcutaneous injections of Tovaxin over a period of 20 weeks (0, 4, 12 and 20 weeks) and were monitored for an additional 32 weeks.

The safety profile for all dosage levels revealed no severe adverse reactions related to T-cell vaccination. With increasing dosage, an increase in mild injection site reactions was observed and these resolved within 48 hours.

All subjects currently are enrolled in an extension study to collect longitudinal safety and effectiveness data.

David McWilliams, president and chief executive officer of Opexa, commented, “We are particularly encouraged by the data from this dose escalation trial. While all three dosage levels were safe and effective, the group treated with the 30 – 45 x 106 T-cell dose achieved a 100% reduction in ARR. The currently enrolling Tovaxin IIb clinical trial is being conducted with the 30 – 45 x 106 T-cell dose.”

About TERMS

The Tovaxin Phase IIb clinical study will include 150 patients in a multicenter, randomized, double blind, placebo-controlled trial designed primarily to evaluate the efficacy, safety and tolerability of the Tovaxin T- cell vaccination with clinically isolated syndrome (CIS) and relapsing-remitting MS (RR-MS) patients. A total of 100 patients will receive Tovaxin, while 50 will receive placebo. The study is designed as a two-arm, 52-week, parallel-group study, whereby patients will be given five subcutaneous injections at 0, 4, 8, 12 and 24 weeks. The analyses will be performed at the end of the 52-week study to assess the safety and efficacy of Tovaxin. The primary efficacy variable is the cumulative number of gadolinium-enhancing lesions on T1-weighted MRI scans summed over the Week 28, 36, 44, and 52 MRIs. The secondary efficacy variables are the cumulative number of new gadolinium-enhancing lesions at Weeks 28-52, the change in T2-weighted lesion volume, and the annualized relapse rate. As of March 19, 2007, Opexa reported that more than 110 patients have been enrolled in the TERMS clinical trial and the Company expects enrollment to be complete by mid 2007.

All patients who complete the trial will be eligible to participate in an optional one-year extension study, in which they will receive Tovaxin under an open-label protocol. The open-label study is being planned under a different protocol that will be submitted to the FDA.

The TERMS study is being conducted at 36 U.S. sites to evaluate the safety and effectiveness of Tovaxin It is registered on the U.S. National Institutes of Health-sponsored website, www.clinicaltrials.gov, where pharmaceutical companies are required to register trials for medicines that will treat serious or life-threatening diseases or conditions. For more information, visit the TERMS website at www.tovaxin.com.

About T-cell Vaccination

For a T-cell vaccine to be effective, it should be able to induce T-cell cytotoxic and/or regulatory immune responses against the pathogenic T-cells. Studies of T-cell vaccine have indicated that T-cell vaccination with peripheral blood-derived autologous myelin-peptide selected T-cells in multiple sclerosis patients resulted in the in vivo induction of CD8+ cytotoxic T-cells and CD4+CD25+FoxP3 Tregs specific for T-cell vaccine. The induction of anti-idiotypic cytotoxic CD8+ effector T-cells and anti-ergotypic CD4+CD25+FoxP3 positive Tregs is believed to provide a therapeutically effective dual mechanism of protection to patients treated with Tovaxin™. The observed regulatory immune responses have been shown to collectively correlate with clinical improvement in treated patients.

About Opexa Therapeutics

Opexa Therapeutics develops and commercializes cell therapies to treat autoimmune diseases such as MS, rheumatoid arthritis, and diabetes. The Company is focused on autologous cellular therapy applications of its proprietary T-cell and stem cell therapies. The Company's lead product, Tovaxin(TM), a T-cell therapy for multiple sclerosis is in Phase IIb trials. The Company holds the exclusive worldwide license for adult multipotent stem cells derived from mononuclear cells of peripheral blood. The technology allows large quantities of monocyte derived stem cells to be produced efficiently for use in autologous therapy, thus circumventing the threat of rejection. The Company is in preclinical development for diabetes mellitus. For more information, visit the Opexa Therapeutics website at www.opexatherapeutics.com.

Safe Harbor Statement

This press release contains "forward-looking statements," including statements about Opexa Therapeutics' growth and future operating results, discovery and development of products, strategic alliances and intellectual property, as well as other matters that are not historical facts or information. These forward-looking statements are based on management's current assumptions and expectations and involve risks, uncertainties and other important factors, specifically including those relating to Opexa Therapeutics' ability to obtain additional funding, develop its stem cell technologies, achieve its operational objectives, and obtain patent protection for its discoveries, that may cause Opexa Therapeutics' actual results to be materially different from any future results expressed or implied by such forward-looking statements. Opexa Therapeutics undertakes no obligation to update or revise any such forward-looking statements, whether as a result of new information, future events or otherwise.

Editor's Note:

In first and fourth paragraphs of this release, T-cell dosage levels include the figure 10(6), which should be read as ten to the sixth power.
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Post by IHaveMS-com »

Hi Bob,
The following is the press release I was referring to which seems to mean that the mid-dose proved 100% effective in the elimination of mrtc's AND 100% reduction in annual relapse rate.
Boy, this stuff is even better than I thought. I always use the lesser value obtained from the entire study.
The “per-protocol” analysis of Tovaxin therapy achieved a 90% reduction (p = 0.0039) in annualized relapse rate (ARR) in subjects who received one of the three dosage levels;
The mid-dose is a subset of that study, but it is the dose that everyone is getting in the current IIb trial, and for that reason, it is good to point out those results.

I usually check email before I go to bed. I must have been dreaming last night, because I would swear there was a picture on this thread of a proud graduate surrounded by her family and a pretty fancy cake. Maybe I need to add hallucinations to my list of symptoms.
Best regards, Tim

In 2001, my family helped fund the startup of Opexa. My father served on the Board of Directors of PharmaFrontiers, now Opexa Therapeutics, until the company completed a successful 23-million dollar financing round.
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Post by robbie »

MS, rheumatoid arthritis, and diabetes.
Sounds like my wife and i can both benefit from this.
Had ms for 28 yrs,
8.5 EDSS
SPMS, 54 yrs old
Taking it day by day
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