Open-Label Study to Evaluate the Efficacy of ECP in Secondary Progressive Multiple Sclerosis

Inclusion Criteria:

Patients with SPMS based on the Recommended Diagnostic Criteria for MS and clinical course.
Demonstrate EDSS scores between 3 to 6.5 at screening.
Documented EDSS progression in the 2 years prior to screening of 1 point or greater for patients with an EDSS score less than 6 at baseline, and greater than or equal to 0.5
Documented absence of clinical relapse within 2 years of screening
Age ≥ 18 ≤ 75 years
Weight > 40≤ 150 kg.
Absolute Neutrophil count ≥ 2,000 per μL
Hematocrit ≥ 28 % and platelet count > 100,000 per μL (with or without transfusion support)
Willingness to use at least 1 reliable method of birth control (e.g. abstinence, oral contraceptives, intrauterine devices, barrier method with spermicide, or surgical sterilization) throughout the study for all men and women of childbearing potential
Willingness to participate in all study visits and procedures, as outlined in the informed consent
Patients able to give informed consent.
Patients must have adequate peripheral venous access to initiate ECP therapy.

Exclusion Criteria:

Absolute medical contraindication to corticosteroid treatment
Absolute medical contraindication to receive ECP
Clinical relapse within 2 years of screening

Laboratory evidence of any of the following:

WBC < 2,000 cells per uL
Serum transaminase levels > x 2 UNL
HgbA1C > 6%
Concurrent diagnosis of a neurological condition or autoimmune disease other than MS
Evidence of known infection with human immunodeficiency virus (HIV) or active (not including latent) Hepatitis B (laboratory testing is not required if virus status is already known)
Uncontrolled infection requiring treatment at study entry
Hypersensitivity or allergy to psoralen (methoxsalen)
Hypersensitivity or allergy to both heparin and citrate products (If hypersensitive or allergic to only one of these products, exclusion does not apply)
Inability to tolerate fluid changes associated with ECP (e.g. inadequate renal, hepatic, pulmonary and cardiac function leading to enable patient to tolerate extracorporeal volume shifts associated with ECP)
Presence of aphakia or photosensitive disease (systemic lupus erythematosis, porphyrias, albinism, etc.)
Women who are pregnant and/or lactating.
Use of any investigational drug/treatment at the time of enrollment or within the previous 60 days, or five elimination half-lives, or until the expected pharmacodynamic effect has returned to baseline, whichever is longer.
Initiation of dalfampridine or change in the dose of dalfampridine within 6 months prior to randomization

Treatment with any of the medications or procedures listed below:

Glatiramer acetate, interferon-beta, fingolimod, teriflunomide or dimethylfumarate within 3 months prior to randomization
Natalizumab within 6 months prior to randomization
Cyclophosphamide within 1year prior to randomization
Mitoxantrone within 2 years prior to randomization
Rituximab, ofatumumab, ocrelizumab, cladribine, daclizumab within 2 years prior
Intravenous immunoglobulin within 6 months prior to randomization
Plasmapheresis within 1 year prior to randomization
Corticosteroids within 3 months prior to screening
Inability to undergo MRI scans
Contraindication to gadolinium due to past allergic, hypersensitive or adverse reaction or impaired renal function
Any other disease or condition which, in the opinion of the investigator, could interfere with participation in the study according to the study protocol, or with the ability of the patients to cooperate and comply with study procedures.
Poor venous access
Previous history of skin cancer, leukemia/lymphoma/myeloma or bone marrow transplant.
History of cataracts
Patients taking Coumadin who are unable to switch from oral anticoagulants to enoxaparin.