MS Treatments Delay Progressive Disease

Research Summary: Association of Initial Disease-Modifying With Later Conversion to Secondary Progressive Multiple Sclerosis

In mid-January, we had the good fortune of getting to break some major multiple sclerosis research news.  Essentially, for the first time, a study had provided evidence that MS treatments are actually effective in providing long-term benefits.  You can read the text summary below or watch Brett provide a video summary of this research at the base of this article.

WHAT?

A research project asking whether current disease modifying therapies (DMTs) for multiple sclerosis delay the onset of secondary progressive MS (SPMS).

WHO?

The research was led by the Clinical Outcomes Research (CORe) Unit at The University of Melbourne, Australia.  The lead author of the paper, Dr Will Brown, performed the analysis while part of the CORe Unit and is also associated with The University of Cambridge, UK.

HOW?

The study utilised the MSBase Registry.  This contains large amounts of long-term clinical data from people living with multiple sclerosis from many countries around the world.  In this study, the information from more than 1500 people with MS was analysed.

WHERE/WHEN?

The study was published in JAMA (the third highest ranked medical journal in the world) in January, 2019.

FINDING #1:  Treatments are effective in the long-term.  The study found that the group of people on treatment (in this study that included interferons, Copaxone, Tysabri, Gilenya and Lemtrada) had a delayed time to the onset of SPMS compared to people who were not taking any DMTs.

FINDING #2:  The newer, more ‘powerful’ treatments are more effective at delaying the onset of SPMS.  The study found that taking Tysabri, Gilenya and Lemtrada resulted in a longer time to transitioning to progressive disease.

FINDING #3:  The earlier that treatment was begun after disease onset, the better the long-term outcomes.  In particular, they found that starting the therapy within the first 5 years, provided the best benefits in terms of delaying progressive disease.

THOUGHT #1:  This gives the MS community and healthcare professionals additional confidence in the use of currently available treatments for multiple sclerosis.  Whilst it has been clear that they are effective at having short-term benefits (e.g reducing the number of relapses), it is great to see that they are also working in the longer-term to prevent the onset of progressive disease.

THOUGHT #2:  It provides more evidence that the most effective way to treat multiple sclerosis with DMTs is to use an aggressive treatment approach at an early stage.  Obviously, this decision has many other factors that have to be taken into account (e.g side-effects, family planning, employment etc).  However, this study allows people living with MS to make decisions with confidence when selecting the best DMT for them.

The abstract for this study can be read in full here.

VIDEO SUMMARY