Monday, December 18, 2006

Health Scan: Study shows treatment should begin with first MS attack

Dec. 16, 2006 21:03 | Updated Dec. 17, 2006 13:24


Neurologists almost always wait until a second attack of symptoms before diagnosing multiple sclerosis - the potentially severe and incurable autoimmune disease in which the myelin coating of the nerves in the central nervous system is attacked by the body. Only then do they try to treat it with Copaxone or various types of interferon injections to slow the frequency of attacks and reduce their severity.

The fewer the attacks - which can involve a tingling of the extremities, muscle weakness or paralysis, blurred vision, tics, slurred speech, vertigo and swallowing problems, among others - the less the accumulated disability, thus delaying attacks and minimizing their long-term effects.

New research, however, indicates a need to take action with the first symptoms, says Prof. Mark Freedman, a senior neurologist at the University of Ottawa and head of the MS research division at the Ottawa Hospital General Campus.

Freedman, who was born in Toronto but speaks near-fluent Hebrew after studying at the Weizmann Institute as well as in London and Montreal, was in Israel recently to present this new research at a meeting of the Israel Society for Neuroimmunology.

The published clinical trial examined the results of treating patients with initial symptoms and whose MS was confirmed by magnetic resonance imaging. Some of the patients received interferon beta (Betaferon of Schering Pharmaceuticals) injections immediately, while others waited for subsequent attacks.

"Confirmed patients should be started on the drugs immediately; if you wait for the second attack, they don't work as well," Freedman told The Jerusalem Post. All patients are going to be studied for at least five years.

The two-year study showed that early intervention is effective in delaying attacks and reducing their severity. When the medication is injected every other day, patients were half as likely to develop the full-fledged disease.

"It is not a cure, but it could push disability far into the future," said Freedman, who urged neurologists to take a proactive approach.

"Using clinical criteria and MRI, we can know in 85% to 90% of patients when it is MS. It is not wise to wait for therapy, even though the drugs are expensive."

Early intervention, he said, would probably work for Teva's Copaxone and Biogen's Avonex or Serono's Rebif (both interferon beta 1-a), and not only for Schering's Betaferon (interferon beta 1-b). Preliminary studies have already been started abroad on interferon beta 1-a and Copaxone, he said.

Some researchers are giving MS patients two or more kinds of medications simultaneously, as this may have a synergistic effect, he said.

Freedman is quite hopeful there will eventually be a cure for MS.

"We in the field have made substantial progress in the past two decades, and new agents are being developed. Stem cells could someday be used to heal the myelin or cause regeneration."