MS Drug Shows New Promises
Researchers have demonstrated that a drug used to control multiple sclerosis can sharply slow the rate at which people develop the crippling nerve disease, a new study shows.
The results of an new international study have been so promising, in fact, that researchers actually stopped the research early to give patients in the placebo group the chance to have the treatment.
Interferon beta-1a, known by the brand name Avonex, is one of three drugs doctors offer to reduce the frequency and severity of attacks and slow the progression of the disease. Patients are also given steroids to reduce inflammation during each attack
Results of the three-year study to be published in Thursday's issue of New England Journal of Medicine led researchers to believe thousands of patients that currently don't get treatment until they have substantial brain or nerve damage could be helped.
The study - conducted on 383 patients who had one symptom of MS but were not diagnosed with the disease - found that 44 percent of the patients taking Avonex had their symptoms delayed versus those taking a placebo.
"I expected to have more side effects than I've had. I expected to be depressed or to have more attacks and I haven't," said Marion Hedger, who suffers from MS and participated in the study at the Wiell Cornell Medical Center in New York. "I think a lot of people have said to me that they wouldn't know I had MS unless I actually told them."
Hedger hasn't been told officially if she was given Avonex or the placebo. But she said she has no doubt that she was given the drug and is very pleased.
The treatment consists of injecting the drug into the patient's body once a week. And it doesn't come cheap.
Produced by Biogen, Avonex costs a patient approximately $10,000 a year.
And some researchers make a point to inform MS sufferers that the treatment and drug are not the final answer to extinguishing the disease, reports CBS News Health Correspondent Dr. Emily Senay.
But multiple sclerosis patient Bonnie Dank is confident that the use of the drug to treat the disease can be helpful to other MS patients.
"Get the diagnosis and get on the drug fast," Dank said.
The key to the success of using the drug, researchers said, is early treatment.
Dank was one of the patients involved in interferon trials conducted by scientists at State University of New York School of Medicine at Buffalo and she has been taking the drug for the last four to five years.
Before she started with the drug, Dank said the disease had affected the vision in one of her eyes and she suffered weakness on her right side. "I still have a little weakness, but not the way I had it at the time."
Until now, people who suffer inflammation of nerves in the eye, spinal cord or lower brain - indications that MS might be developing - have not been diagnosed with the autoimmune disorder, let alone treated. The diagnosis only follows second flare-up in the central nervous system.
Only one-third of patients who gave themselves weekly thigh injections of the drug developed MS within three years, compared with half the patients who injected a placebo.
"It's a very important finding because it really shows if one starts treatment early on, one can change the fate of a patient," delaying or even preventing the onset of the disease, said Dr. Thomas Leist, director of the Comprehensive Multiple Sclerosis Center at Thomas Jefferson University in Philadelphia.
Dr. Stephen Reingold, vice president for research programs at the National Multiple Sclerosis Society, said the findings will push doctors to promptly order magnetic resonance imaging in patients with an initial nerve flare-up.
If brain lesions - scarring that indicates past inflammation - are spotted during the MRI, Reingold said, "it should encourage treatment with this interferon."
In multiple sclerosis, the body's immune system goes awry and attacks the nerves and brain, slowly stripping away the protective "insulation" coating nerve fibers. That damage builds up over years to cause muscle weakness or paralysis, fatigue, dim or blurred vision, memory loss and other problems with thinking.
Some people merely suffer mild weakness for decades, while others steadily worsen from repeated attacks.
Avonex is a genetically engineered replica of a naturally occurring human protein. It works by reducing inflammation and quieting down the overactive immune system, said the lead researcher, Dr. Lawrence Jacobs, professor of neurology at SUNY-Buffalo and head of neurology at Buffalo General Hospital.
Along with delaying the onset of MS, Avonex cut the number of new or actively inflamed lesions detected by MRIs by more than half, compared with patients in the comparison group. It also cut the total volume of such lesions in the nervous system by 91 percent over the comparison patients, Jacobs said.
European researchers recently came up with a similar finding on Avonex's effects when it is used early.
The 383 people in the latest study had suffered an initial nerve flare-up and had at least two brain lesions detected by an MRI, Jacobs said.
Until MRIs recently enabled doctors to see inside live brains, they would not begin treatment for MS until the second nerve flare-up confirmed the diagnosis; in about half the patients, something else, such as infection, caused the initial inflammation.
"In the meantime, half of them have lesions in the brain that are smoldering and doing further damage," Jacobs said.
About 350,000 Americans have multiple sclerosis, and one-fifth of them are in this group with "silent" brain damage who could be helped by aggressive treatment. Leist said its price tag of about $10,000 annually could limit use.
Leist also said that patients need to be followed for longer than three years to determine how long they need the interferon treatment and tht other MS drugs should be studied to determine if there are similar benefits when given earlier.