CMSC INforMS: Treating Multiple Sclerosis Early Can Bring Benefits, Delay Relapses
Wednesday, August 10, 2016
Posted by: Elizabeth Porco
Getting an early head start on treating multiple sclerosis (MS) may bring dividends years down the road, find a new study published Wednesday in Neurology.
In 2005, researchers recruited 468 patients who had the earliest signs of MS, such as troubles with vision or balance and suggestive brain lesions found via an MRI scan, to be placed into two groups. One group immediately received a standard treatment for MS, regular doses of interferon beta-1b, while the other received a placebo for as long as two years before being switched onto interferon or another drug. Over the course of the following 11 years, the researchers kept track of how the patients progressed, including whether they developed full blown MS. Of the remaining 278 patients in the study, they found that the early treatment group was 33 percent less likely to be diagnosed with clinical MS than those given delayed treatment. It also took them twice as much time to come down with the first relapse of the disease and they experienced less relapses annually.
“Not much research has been done on how starting treatment this early affects the long-term course of the disease,” and lead author Dr. Ludwig Kappos of the University Hospital Basel in Basel, Switzerland in a statement. “Our study adds to the evidence supporting treatment at the earliest sign of the disease and indicates that early treatment has a long-lasting effect on disease activity.”
Multiple sclerosis is a progressive brain disorder in which the immune system gradually eats away the myelin sheath that covers and protects the nerve fibers of our brain and spinal cord. This corrosion wreaks havoc on our ability to communicate, move and even remember, among many other bodily functions. MS can vary in severity and presentation, but almost all experience a sudden episode of neurological symptoms at first. From there, the majority experience acute flare-ups of the disease that interrupt long periods of seemingly symptomless days, while a smaller few continuously get worse over time. Eventually, though, just about all patients enter a stage of worsening neurologic function, a condition known as secondary progressive MS (SPMS.)
Drugs like interferon beta-1b have been shown to reduce the frequency and severity of flare-ups, but unfortunately, they don’t seem to actually help reduce or prevent the actual damage being done to the brain, even when taken as early as possible. Indeed, the researchers of the current study found there were no differences in neurological damage or overall disability experienced between the groups.
“Overall, early treatment appears to have a benefit on relapses, especially early in the disease, but limited effects on the other outcome measures, including outcomes reported by patients,” wrote Dr. Brian C. Healy, a neurologist at Brigham and Women’s Hospital and Massachusetts General Hospital in Boston, in an accompanying editorial.
As of now, though, only 5.9 percent of the patients had entered the SPMS stage of the disease, with the early treatment group slightly less likely to do so.
By Ed Cara
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