August 30, 2019 at 12:35 pm #340
Treating the earliest signs of multiple sclerosis with the drug interferon beta-1b may reduce the risk of a definitive diagnosis of the condition. It may well help reduce relapse following a definitive diagnosis. These are the findings of new research published in the journal Neurology.
Early symptoms of MS include numbness or tingling of the face, body, or arms and legs, fatigue, loss of balance, dizziness, and vision problems. Most people will not experience all of these but many will get more than one. It is a toss up as to which one(s) any person will get, as MS is a very personal disease. By that I mean that it is unique to every person and it doesn’t seem to follow the same path with any two MSers.
Treatments for MS
There is currently no cure for MS, but there are treatments that can help patients manage their symptoms. Interferon beta-1b is one such treatment. This is marketed under the trade name Betaseron. This drug is used to reduce symptoms in patients with relapsing-remitting MS (RRMS). RRMS is characterized by attacks of symptoms that arise, before improving or disappearing completely.
Study co-author Dr. Ludwig Kappos, of University Hospital Basel in Switzerland, and colleagues note that there has been little investigation into how starting this treatment at the earliest stages of MS may affect disease progression.
For this study 468 individuals who were showing early signs of MS, but who had not yet been diagnosed with the condition, were enrolled. The participants were randomly assigned to one of two groups. One group received early treatment with interferon beta-1b, while the other received a placebo.
After 2 years or a diagnosis of MS – whichever came first – subjects who had been taking the placebo were allowed to switch to interferon beta-1b or another MS drug of their choice.
Likelihood of MS diagnosis 33 percent lower with early treatment
Eleven years after study initiation, 278 participants remained, of whom 167 had received early treatment with interferon beta-1b and 111 had received delayed treatment with the drug.
Those participants that received early treatment with interferon beta-1b were 33% less likely to have received a definitive diagnosis of Multiple Sclerosis. Another finding of the study was that participants that received the early treatment also experienced a delay in their first relapse. The group that received early treatment had their first relapse at an average of 1,888 days while the control group received their first relapse in approximately half the time at 931 days.
Some Good News About Relapses
There was other good news on the relapse front. The group that received early treatment had an annual relapse rate that was 19% lower than the control group. The control group had an annual relapse rate of 0.26 and the early treatment group had a rate of 0.21.
Additionally, the annual relapse rate was 19 percent lower for participants who received early treatment, compared with those who had delayed treatment, with an annual relapse rate of 0.21 and 0.26, respectively.
Doctors Surprised at Study Results
Dr. Kappos said that the team was very surprised by these results. “The most astonishing observation was that relapse rates remained lower in most of the years after both groups had equal access to treatment,” he noted.
No Difference in Nerve Damage or Severity of Relapses
Even though there was differences in the relapse rates between the two groups, there was no evidence that early treatment meant a difference in the amount of Central Nervous System damage or severity of the relapses that the participants did have.
Long Term Benefits Possible
Based on these study results, Dr. Kappos said patients in the early stages of MS may see long-term benefits with the use of interferon beta-1b. “It was reassuring to see that little progression occurred in both treatment groups over these 11 years. For me this underlines that – although the options are better with a very early intervention – the window of opportunity remains open for some time.”
More Study Still Needed
“It was reassuring to see that little progression occurred in both treatment groups over these 11 years. For me this underlines that – although the options are better with a very early intervention – the window of opportunity remains open for some time.”
The researchers say their study – which was funded by Bayer HealthCare Pharmaceuticals – does have some limitations.
One study limitation that they noted was that both the patients and researchers learned which subjects were taking interferon beta-1b or placebo after fifth-year tests. Additionally, they note that all participants were receiving treatment after the first 2 years, meaning there was no longer an untreated control group.
Dr. Kappos told us that he and his team now plan to assess whether other compounds that work in a similar way to interferon beta-1b, but which are more effective, may be beneficial if given to patients in the earliest stages of MS.
“A burning but not easy-to-resolve question is if these results that were achieved with Interferon beta 1b – a ‘first-generation’ compound – would be further improved by treating as early with one of the more recently developed treatments that have shown more efficacy in established relapsing MS,” he said. “Similarly we need to improve on our ability to predict who are the best candidates for this treatment.”
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