News & Views€¦ · 2017 News & Views Spring/Summer What Is Happening In Clinical Trials In CIDP Submitted by Vera Bril, MD This is an exciting time for patients who need immunoglobulin

News & Views Issue: 2017 Spring/Summer Honorary Board Larry Brenneman (deceased) Susan Keast Serge Payer Kenneth Shonk, MD Tom Feasby, MD

Executive Director Donna Hartlen Officers Demetrios Strongolos President Sherry Nejedly Vice President Howard Huss Treasurer Board of Directors Kim Brooks Jane Field Howard Huss Wilma J Koopman Sherry Nejedly Demetrios Strongolos Medical Advisory Board Steven Baker, MD Brenda Banwell, MD Timothy Benstead, MD Pierre Bourque, MD Vera Bril, MD Colin Chalk, MD Kristine Chapman, MD Angela Genge, MD Gillian Gibson, MD Angelika Hahn, MD Hans Katzberg, MD Kurt Kimpinski, MD Rami Massie, MD Elizabeth Pringle, MD Zaeem Siddiqi, MD Jiri Vasjar, MD Chris White, MD Douglas Zochodne, MD Proudly Supports

A VERY Short Message from your Executive Director, Donna Hartlen We apologize for the delays, but we have held back the distribution in part to include evolving CASL rules and programs. You’ll see that we have a lot of exciting medical news, have enjoyed successful events this spring, and we will soon have a Canadian website up and running for the New Year. Bookmark gbscidp.ca! Most important for me at this time is to extend my sincere thanks to Susan Keast, my mentor and friend, for her willingness to share her knowledge and wisdom since I began in 2013. She has dedicated more time to all of us than you can imagine and now she has officially retired and will spend some much deserved time with her family. I am very pleased to announce she has been given a designation on the foundation’s Honorary Board. We’re not letting her go too far! While you are relaxing during our short Canadian summer, please consider how you can help the foundation. Please review page 11 for ideas, every little bit helps! Wishing our BC families relief from the wild fires. Enjoy your summer! Warmly, Donna

3100 Garden Street, PO Box 80600 RPO Rossland Garden, Whitby, ON, L1R 0H1 www.gbs-cidp.org/canada | Canadian registered charity: 887327906RR0001

GBS/CIDP Foundation of Canada Guillain-Barré Syndrome / Chronic Inflammatory Demyelinating Polyneuropathy

Support, Education, and Research

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Issue: 2017 News & Views Spring/Summer

A Message from your President Jim Strongolos

I would like to express my thanks to all the directors, liaisons, volunteers, and sponsors for their continued support. Mostly, I wanted to say a BIG thank you to our mentor Susan Keast, as with her support and efforts, made this Canadian Foundation the big success story that it is. Susan will now officially retire from the foundation, but will continue to be only a phone call away if we need her. On a personal note, Susan Keast was my support contact when I was inflicted with GBS back in 1997. She was the reason that I am involved with our Foundation since then. THANK YOU SUSAN. Times are changing so fast and with all the desirable programs and challenges ahead, we need to continue with our roles as VOLUNTEERS, with the main focus being the support of patients and their families. We all have been there and know what it means to talk to someone that understands fully the implications and suffering that everyone with GBS/CIDP/MMN and variants goes through. It is so important to continue with our VISION and MISSION, but also and equally as important, to request the continued support from our sponsors in order to facilitate and support the GROWTH that we plan for our continued success. Jim

P2 GBS/CIDP Foundation of Canada

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What Is Happening In Clinical Trials In CIDP Submitted by Vera Bril, MD

This is an exciting time for patients who need immunoglobulin (IG) to treat their CIDP. The common treatment is intravenous (IV) infusions that are done every three or four weeks or at other intervals. IVIG treatment

involves attending an infusion site that is managed by a nurse and spending at least half a day or longer getting the infusion. The treatments can interfere with work or other activities and after a while, it may be very difficult to get access to the veins. Some people have had to have Port-a-caths placed into their veins; this means a permanent access line into their veins with the risks of infection and bleeding. As you all likely know, CSL has done a study on subcutaneous administration of immunoglobulin, or SCIG, to determine whether this different method of giving healthy immune molecules would be effective in patients with CIDP as well as safe compared to standard intravenous administration of IG. The study also wanted to determine what kind of side effects would be experienced by patients on chronic SCIG. This study has been completed and a poster just presented at the American Academy of Neurology meeting in April is that the results were positive. CIDP patients can be maintained on SCIG effectively giving more independence to those needing chronic treatment. More details about the study findings will be available in the next few months. It is likely that regulatory authorities will look favorably upon the administration of immunoglobulin by the subcutaneous route in CIDP. The benefits to patients are the increased freedom to give the IG at home at a time convenient to the patient with possibly fewer side effects, and the benefit to the system is that nursing supervision for SCIG treatments is not required.

Along this line, Baxalta, now part of Shire, formally known as Baxter, is also running a study on giving subcutaneous immunoglobulin, but mixed with a compound, hyaluronidase, (HyQvia) that improves the absorption of immunoglobulin when it is injected beneath the skin, and this will possibly improve how SCIG works for CiDP. This study is active now and recruiting patients. Again, we are hopeful that patients who receive the subcutaneous immunoglobulin with hyaluronidase, HyQvia, may have fewer problems with headaches and other side effects compared to the intravenous route. There is a question of whether the different types of IVIG (Gamunex, Privigen, NewGam, Panzyga, etc.) all have the same side effects or whether some products have more side effects than others or whether the side effects are related to the particular batch of IVIG regardless of the manufacturer. Octapharma is planning a study to put CIDP patients on NewGam to determine whether their side effect profile is lower compared to other IVIGs that they may have been treated with before. At the same time, they are planning to withdraw Octagam, so any patients on this IVIG will need to transition to other products. Octapharma is also running another study on assessing how quickly IVIG (Panzyga) can be given to CIDP patients and if there is anything in the clinical status of patients that determines this rate. Currently maximum flow rates are somewhat arbitrary, but there is the impression that side effects are increased with faster flow rates and some side effects are treated by reducing the flow rates of IVIG. However this impression needs to be understood better than it is now because it may be faulty. If we find that patients tolerate faster infusions without difficulties, then it may reduce the time that a patient has to be in the infusion suite to receive treatment. -> continued next page

GBS/CIDP Foundation of Canada P3

Issue: 2017 News & Views Spring/Summer What Is Happening In Clinical Trials In CIDP (continued) Despite the positive effects of IVIG or SCIG, we know that not all patients with CIDP will respond to immunoglobulin therapy. Beyond IG therapy, new compounds are being developed that may have a positive effect on CIDP. Unfortunately, the fingolomid study was negative, so this drug did not help patients with CIDP. UCB is in the process of developing an Fc receptor inhibitor that will block one part of the immune molecule, be more easily administered, and may be effective in controlling CIDP. This study is planned to start sometime over the next year or so. In summary, there are many exciting studies going on that look at different ways to give immunoglobulin, to assess the safety profile of different infusion rates of IVIG, to compare side effects with a particular brand of IVIG, and to assess new immune molecules for their effect on this challenging disorder. If you are interested in being considered for any of these studies, please reach out to Donna for more information, or to Ed Ng, research manager at the Neuromuscular Clinic at UHN, 416-340-3898.

*** 2017 Walter Keast Award ***

We are now accepting nominations for the 2017 Walter Keast Award until Oct 28, 2017. This year the foundation will award a volunteer and/or a clinic. Those awarded will be announced in the fall/winter publication. Please submit a letter describing why you think the nominee should be put forth for consideration.

Submit to:

[email protected]

or

GBS/CIDP Foundation of Canada 3100 Garden Street

PO Box 80060 RPO Rossland Garden Whitby, ON L1R 0H1

“To be awarded annually by nomination to an individual that exhibits an exemplary

commitment to the GBS-CIDP community.”

Thanks to everyone that attended the first Calgary Support Group Meeting on April 28, 2017

To be added to the group email list for upcoming meetings in Calgary, please email [email protected]


2017 News & Views Spring/Summer

IVIG-associated hemolysis: Its causes and potential resolution

Submitted by Dr. Donald Branch

Intravenous immunoglobulin (IVIG) was initially prescribed as replacement therapy for patients at risk of infection from hypo- or dysgammaglobulinemia. Indeed, IVIG is processed from thousands of pooled individual-donor plasmas and contains millions of IgG antibodies targeting various pathogens. Therefore, it is highly effective at relatively low doses as a replacement for antibodies lacking in people that have acquired or congenital problems with normal levels of antibodies that fight infections. Following the serendipitous discovery in 1981 of immunomodulatory effects of IVIG when prescribed in high doses, it has increasingly been used for the treatment of various autoimmune

diseases and inflammatory conditions, such as Guillain-Barré Syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP). Although frequently effective and usually benign, IVIG therapy can result in hemolysis, causing anemia in the patient, which in some cases is life-threatening in severity. The mechanism by which this hemolysis occurs is not completely understood but appears to involve the binding of antibodies called isoagglutinins (anti-A, anti-B and likely anti-A,B) within the final IVIG product that target the patient’s ABO blood group. Thus, patients that are of blood group O are unlikely to have problems with IVIG-associated hemolysis, but those patients that are of blood group A or B or AB are at some risk. Furthermore, the risk of hemolysis is associated with high-dose IVIG in these patients, doses of ≥2 g/kg are usually associated with the hemolysis. Also, not all patients that receive IVIG will hemolyze, despite receiving high-doses and being of the appropriate ABO blood type. The reason for this is unclear but likely involves factors in the patient that contribute to the hemolysis. In Toronto, we have found the incidence of IVIG-associated hemolysis to occur in about 35% of patients who receive ≥ 2g/kg IVIG and are non-blood group O. Most of these hemolytic episodes are not severe and patients recover quickly. All IVIG products contain the isoagglutinins that can cause hemolysis. Companies surmised that if the anti-A or anti-B in their products caused the hemolysis, reducing the levels of these antibodies may diminish or eliminate the problem. Thus, companies have begun to select plasma donors with lower levels of these isoagglutinins prior to preparation of the IVIG. Other companies have taken the reduction in the isoagglutinins to another level in that they utilize a process that actively removes the antibodies from the pooled product, this product is Privigen and termed IsoLo. To date, there are no peer-reviewed publications that show that either selection of donors having lower titers of these isoaggulinins and/or using methods to actively remove these from the final product will result in less hemolysis following IVIG therapy but, conceptually, it should. Studies are currently in progress to determine if these approaches do, in fact, reduce the incidence of IVIG-associated hemolysis.

GBS/CIDP Foundation of Canada is working to expand online service

for our Canadian patient community

Bookmark it! gbscidp.ca



International GBS Outcome Study Submitted by Dr. Tom Feasby

The International Guillain-Barre Syndrome Outcome Study has reached two important milestones. It has now entered its 1500th patient with GBS, a remarkable number. These patients come from all over the world, 30 of them from Canada. Also, the scientists have begun the analysis of the data, beginning with the database of the first 1000 patients entered into the study. In fact, the first paper to come out of this work was just published in April (on line) in the Journal of the Peripheral Nervous System as: International Guillain-Barré Syndrome Outcome Study (IGOS):Protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome Bart C. Jacobs, Bianca van den Berg, Christine Verboon, Govindsinh Chavada, David R. Cornblath, Kenneth C. Gorson, Thomas Harbo, Hans-Peter Hartung, Richard A.C. Hughes, Susumu Kusunoki, Pieter A. van Doorn, Hugh J. Willison and the IGOS Consortium++

The link to the paper is: http://onlinelibrary.wiley.com/doi/10.1111/jns.12209/abstract?campaign=wolacceptedarticle This paper describes the characteristics of the group of patients and the overview of the study. Other studies are now ongoing or planned and will look at the outcomes (recovery etc), the value of testing and the clinical features in predicting outcome, and differences between countries and regions, and many other questions. Any of the doctors or scientists in any of the countries is invited to join the groups working on these and other research questions. We expect much more fruitful research to emerge that will help us understand the causes of GBS, why some are affected more than others, and perhaps why some recover better. We hope it will also provide guidance as to which people will respond best to which treatments. We are now at a very exciting stage in this very large project.

Educational Events Spring 2017

Many thanks to all that attended our

Educational Afternoons in spring 2017 in London and Edmonton. Our educational events could not be possible without the help of medical professionals, volunteers,

and our sponsors. We recognize the following individuals for their volunteer

participation in the success of these events.

London: Dr. Kurt Kimpinski, Dr. Derek Debicki, Dr. Tim Doherty, Wilma Koopman,

Barb Sherman, Troy Boettinger

Edmonton: Dr. Zaeem Siddiqi, Dr. Douglas Zochodne, Dr. Cecile Phan, Marilyn Rose,

Holly Gerlach, Jason Kent, Patricia Casson-Kent, Dennis Larson, and Glennanne Ball



Moving Forward Susan Keast

How do we define “moving forward”? There are so many different explanations – to some it may mean lots of new Foundation ideas, to others it could mean getting over GBS and coping with CIDP and MMN, or it can mean, how do we look at things and decide on what direction to take. I am at a crossroads where I have decided to move forward, and so as of June 30th, I am retiring from the Canadian GBS/CIDP Foundation of Canada. Why a crossroad ? Because there is always the mixed feelings that go along with this. To all of you whom I have spent so many years with, this is not a goodbye, as I believe once we have all become a member of this foundation, we are all always friends and support persons, and so that never changes. We are always there for each other, no matter what “moving forward means”. We are all connected through our common diseases and it has been such a privilege to meet so many of you over the years. While we have all gone through GBS and CIDP with trepidation, we have all had support from each other. That is how all this began. It’s the reaching out to others for that help and support that means so much to each of us, and our families. Once we learn to cope and are in our recovery, we then start to give back in so many ways. Some through the Foundation as liaisons, some on the Board of Directors, some at the community level helping others to know and understand about these rare disorders, and others just being there to sit and listen to our stories and being proud of how well we have done. Where would this foundation be without all this? Where would each of us be without all this? Giving back to others just becomes part of our daily lives as once we know how we depended upon this help and giving, we now have the opportunity to return the love and support to others. No matter where you are in this big country of Canada, GBS and CIDP support is there for everyone. Our doctors, Neurologists, clinicians and nurses are also there reaching out to help. We have come a long we since our humble beginnings and we now can look back and say how wonderful it is to have so many on side to help look for ways to make our lives better. We have the help and encouragement from our pharmaceuticals that have been there for us since the beginning, and they continue their research to again help us and in working with our Neurologists, we hope that cures are in the making. A Foundation is as good as the people who belong and who work hard at making it work. As I move forward I can say that this foundation is now in the capable hands of Donna Hartlen and also an excellent board of Directors. They work hard to make sure that programs and education is available to all. They make sure that each person can get to see their doctors. They stay on top of who is doing research and how it is all going. They will always reach out to make sure no one is lacking in what they need. There is always something new going on so keep in touch so that you don't miss out. Events are happening and fundraising to help keep this foundation afloat. Remember to support your foundation as it supports you. Again I thank each one of you for making my life richer each day. My GBS was a blessing and so now I bless all of you in your lives. Stay well and stay connected.



An Introduction: Kinesiology Submitted by Devon Blackburn

Physical activity and exercise is one of the single most effective ways to prevent and manage chronic disease, enhance recovery from injury or illness, reduce pain and improve the health and well-being of all persons. According to the Public Health Agency of Canada, “physical activity has been shown to reduce the risk of over 25 chronic conditions”. As Diabetes specialist Dr. Ian Blumer says, “That if all the ways exercise helped you were replicated in a drug, it would be considered a miracle drug.” The Ontario Ministry of Health states “regular exercise can reduce the risk of death by 50 percent.” It is clear that physical activity greatly contributes to our overall health and wellness. What may not be clear is WHO the expert on providing physical activity services is and WHY this is important to someone living with GBS and/or CIDP? I will answer these million dollar questions for you, in a moment. First, a little clarification on the profession of Kinesiology. On April 1 2013, Kinesiologists became fully regulated health professionals in the Province of Ontario. As an authority on movement and exercise, Registered Kinesiologists are committed to enhancing the quality of life through the promotion of physical activity and the prevention and management of injury, pain and chronic disease in order to improve overall health and wellness. We are experts in providing active therapy as well as exercise therapy. Registered Kinesiologists have knowledge in human movement in addition to knowledge of exercise. It is important to recognize that movement knowledge is greatly different from exercise knowledge. A common perception is if we simply exercise, we will automatically move better, [(increase our health and wellness, and feel better)]” (Cook, G., Movement – Functional Movement Systems, 2010). Current exercise programming has two inherent problems: some movements are performed too frequently or with too much intensity, and some movements are used too infrequently or with too little intensity. As Gray Cook explains, “the magic recipe [for creating balance, improving health and wellness and the quality of life] is not universal; it is unique to each person’s movement map. […]” (Movement – Functional

Movement Systems, 2010). Registered Kinesiologists have a complete understanding as to how and why people move the way they do, the factors that limit and enhance the capacity for a person to move and the ability to develop strategies to increase that capacity.

Why is this important to you? (here are those answers to the million dollar questions from above)…

Imagine that you are leaving for vacation, tomorrow. You don’t know exactly where you are going or for how long you will be gone, but you do know that it will be either a hot climate or a cold climate. Naturally, you will want to pack everything you can think of that would be appropriate for the climate you are travelling. Chances are you will not need everything you pack, but you will be prepared for ‘whatever’. This scenario is similar to what it is like to live with GBS and/or CIDP.

A Registered Kinesiologist will identify any mobility, stability, or motor control dysfunctions through a thorough postural alignment and movement function assessment. We will then treat any imbalances throughout the body, including poor muscle recruitment and inefficient muscle patterning that lead to postural misalignments and movement dysfunctions. By minimizing postural misalignments and movement dysfunctions, we minimize the turbulence experienced during your relapse periods.

It is almost certain that you will experience ‘vacation’ periods similar to the one described above - these periods can happen without any significant notifications as to when they will occur and for how long. With an understanding of the interconnected systems of the human body, the Registered Kinesiologist is the expert who can assist you in packing your bag for vacation. PRIOR to experiencing your relapse, the Registered Kinesiologist ensures that you are as strong and healthy as possible so that you are prepared going into your relapse period, you can recover more smoothly from your relapse period and you can transition back into your healthy state of being with more ease.



Ensuring a secure supply of plasma for Canada Canadian Blood Services

***GBS/CIDP Foundation of Canada thanks Canadian Blood Services for the permission to reprint this 2016 article from ‘Circulation’, published by Canadian Blood Services. For ongoing updates surrounding plasma from Canadian Blood Services, visit https://blood.ca/en/blood/about-plasma


In Canada, Canadian Blood Services and Héma-Québec collect plasma for manufacturing into plasma protein products. Because Canada does not currently collect enough plasma to meet the demand for these products, some products, such as immune globulins, are purchased from manufacturers that draw on the supply of plasma in the U.S. In fact, about 75 per cent of the immune globulins Canadian Blood Services distributes in Canada are made from plasma donated by paid U.S. donors.

Canada is not alone in its reliance on the U.S. plasma market; most of the world’s plasma supply comes from the U.S. Eighty per cent of the world’s plasma collection centres are in the U.S, and these centres contribute 70 per cent of the world’s supply of source plasma (plasma collected through apheresis). There is concern worldwide that the capacity of one country to be the primary supplier of plasma is not sustainable, and that the risks to a stable and secure supply of plasma protein products are on the rise.

By 2020, global demand for intravenous immune globulin (IVIg) is expected to double over 2010 levels.

Demand for plasma protein products is increasing around the globe, with large new markets developing in China, India and other countries. By 2020, for example, global demand for intravenous immune globulin (IVIg) is expected to double over 2010 levels. Growing concerns about the U.S. plasma collection industry’s ability to continue keeping pace with this steep upward curve in global demand has prompted other countries, such as Australia, to develop new strategies to increase their levels of domestic sufficiency.

As in other countries, continuing to rely on the U.S. plasma market makes Canada, and Canadian patients, vulnerable in the event of a disruption in supply. It is Canadian Blood Services’ responsibility, as the organization accountable for blood and blood products in all Canadian provinces and territories except Quebec, to ensure a secure supply of products for the patients who rely on them.

In the next number of years, Canadian Blood Services will more than triple the amount of plasma we collect, from 200,000 litres per year to 600,000 to 700,000 litres per year. To do this, we will continue to rely on the generosity of Canadians — and our long tradition of voluntary, unpaid donations — to meet the needs of the patients we serve.

The foundation would like to say Thank You to Delta Beverages Inc. for many years of

corporate donation


Upcoming Support Group Meetings

Vancouver and Area Support Group Meeting - Saturday, Sep 16, 2017 1:00 PM to 3:00 PM Surrey City Centre Library 10350 University Dr., Room 418 Surrey, B.C. It is an informal meeting for patients, family members and caregivers. Come and meet others from the GBS/CIDP/MMN community. We will share stories and personal experiences in small group discussions. Refreshments and light snacks will be provided. Please RSVP at the e-mail address below, this will help with planning. Onsite parking is available at $1.50 per hr. also the Sky train station is very close to the Library. We look forward to seeing you in September. [email protected]

St. Catharines and Area Support Group Meeting – In planning stages The foundation is helping to plan a new local support meeting in the St. Catharines area, which is being coordinated by local GBS and CIDP volunteers. Please send an email to [email protected] if you are interested in attending and we’ll add you to the email list. Toronto Support Group Meeting - Sunday, Sep 10, 2017 2:00 PM to 4:00 PM Northern District Library, Room 224 40 Orchard View Blvd (near Yonge and Eglinton) This meeting will be about small group discussions led by our own members. Dealing with Rehab Issues: led by Donna Sparkes Coping with the chronic in CIDP: led by Carol Ambler Hands on Exercises: led by Darren Brooks Issues for Caregivers: led by Hilary Dore If you would like to be added to the Toronto support group email list, please connect with Jane at her email address listed below. Jane Field, Toronto Liaison, [email protected]

Whitby and Area Support Group Meeting - Saturday Sep 23, 2017 1:15 PM to 3:15 PM Whitby Central Library 405 Dundas St W, Whitby, ON L1N 6A1 Join us for our Greater Toronto Area East Kick off support group meeting! Introductions and casual group discussion will be the agenda for this first meeting. Light refreshments will be provided. Patients, family, and friends are welcome! Please RSVP to the email address below for planning purposes. See you in September! [email protected]


Name: ____________________________________Email: ________________________________PH:___________________ Street: _____________________________________City: ______________________ Prov: _____ Postal Code: ________

I would like to receive electronic communications, such as, newsletters, event notices, surveys, support groups, etc. yes

Volunteer Opportunities

Patient Support GBS CIDP MMN Caregiver

Hospital Visitation

Coordinate Support Group Meetings

Telephone/Email Patient Support IF Yes, Caregiver Patient

Awareness

Pamphlet Distribution to Hospital/Medical Clinics

Mall Walks

Personal Story If Yes, Newsletter Article Future Patient/Caregiver Videos

Ideas Welcome: ______________________________________________________________________

Education

Inservice IF Yes, Planning Present Information

Events IF Yes, Planning Setup/Tear Down

Fundraising

Walk and Roll IF Yes, Chair Event Participate

Corporate Fundraise

Golf Tournament IF Yes, Chair Event Participate Ideas Welcome: ______________________________________________________________________

Consider how your business skills can help the foundation. Such As:

IT Social Media Legal Advice Bookkeeping Corporate Event Planner Writer Graphic Design Other: ____________________

Did you tick more than one or two on the form? Consider a Liaison role More Info Please


GBS/CIDP Foundation of Canada is looking for team members in the

Edmonton, Alberta area to join Holly Gerlach (Edmonton Liaison) in

representing GBS-CIDP-MMN and variants in the 5km NERD run, Walterdale Park Sep 16, 2017.

Join us in raising awareness and support

for our disorders!!

For more information on joining Holly’s team, please contact Holly Gerlach @

[email protected] The foundation has been offered a table at the N.E.R.D run to help us build awareness in the community. Glenanne Ball and Marilyn Rose will be there as volunteers representing our foundation. Thanks, Ladies!

We’ll be letting our membership know in early

September how to support Edmonton runners!

DisclaimerInformation presented in the GBS/CIDP Foundation of Canada newsletter is intended for

general educational purposes only, and should not be construed as advising on diagnosis or treatment of Guillain-Barré syndrome, Chronic Inflammatory Demyelinating Polyneuropathy,

or any other medical condition.

Card Alert !!

If you have a loved one in need of a kind note from those that understand what they are experiencing and

have walked the same journey, send a note to [email protected] with a subject line of ‘Card Alert’ and we’ll make sure Pat Sullivan, Ontario Liaison, will coordinate a mailing to the address provided. If a hospital,

please make sure room and bed #s are provided.

News & Views€¦ · 2017 News & Views Spring/Summer What Is Happening In Clinical Trials In CIDP Submitted by Vera Bril, MD This is an exciting time for patients who need immunoglobulin

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