Women’s Health: Early treatment keeps MS at bay

Researchers recommend starting drug therapy for multiple sclerosis even before the diagnosis is confirmed

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A Canadian study suggests early treatment of multiple sclerosis (MS), an incurable nerve disease, can help slow the progression of disability.

In MS, the body’s own immune system repeatedly attacks the protective covering of nerve cells in the brain and spinal cord, causing worsening problems with weakness, muscle co-ordination, vision and other functions. The disease is at least three times more common in women than in men.

Until now, many doctors have taken a “watchful waiting” approach to suspected cases of MS in its early stages, says Dr. Mark Freedman, a study co-author and neurologist at the University of Ottawa. But the new study results support more immediate action.

“Our approach should be much more aggressive,” Freedman says. “We should work very hard to get a diagnosis as quickly as possible, and if nothing else at least discuss the option with patients that they could go on therapy.”

The three-year study involved 468 patients who had a single episode of symptoms suggestive of MS. The participants were randomly assigned to take inactive placebo treatment or the MS drug interferon beta-1b. After two years or upon diagnosis of definite MS, all patients became eligible for drug treatment. The study was funded by Bayer Schering Pharma, which makes interferon beta-1b under the brand name Betaseron.

After three years, patients who had early drug treatment did significantly better than those who were initially on placebo. They were less likely to develop definite MS (37 per cent versus 51 per cent) and were less likely to have progression of disability (16 per cent versus 24 per cent).

Freedman notes most patients were on drug therapy by the end of the first year, which suggests that starting treatment within a year of the earliest suggestion of MS, before a formal diagnosis is usually made, is the key factor. “You can’t sit back and say, well, what’s a year? A year is everything to these people.”