Multiple sclerosis treatments delay progression of the disease

An international study finds multiple sclerosis treatments have long-term benefits, and that early treatment is important.

Researchers at Cardiff University, contributing to an international collaborative study led by the University of Melbourne, have provided new evidence that timely use of currently available disease modifying therapies can be effective in delaying the onset of secondary progressive multiple sclerosis (SPMS). The study demonstrates that early treatment (particularly within five years of disease onset) delayed SPMS.

MS is the commonest cause of chronic progressive neurological disability in young adults in the UK. Onset of disease is most commonly relapsing. However, after a variable interval that can last many years, most patients enter a secondary progressive phase of disease characterised by progressive accumulation of irreversible disability, and for which there is currently no effective treatment.

SPMS can be difficult to diagnose, as the changes in symptoms and disability are often gradual and occur over years. Treating neurologists will try to determine whether an individual’s symptoms and disability has been gradually worsening over a period of greater than six months and in the absence of any acute relapses before deciding if an individual has SPMS.

This stage of disease commonly includes a wide range of physical symptoms, such as weakness, cognitive decline, urinary symptoms, pain and fatigue which have a major impact on quality of life for people with MS. Understanding ways in which we can delay the onset of SPMS therefore represents an important advance in the overall management of MS.

The study analysed data from 1555 patients, in 68 neurological centres across 21 countries.

Professor Neil Robertson, a Clinical Professor of Neurology at Cardiff University’s Division of Psychological Medicine and Clinical Neurosciences said, “People who transition from relapsing MS to secondary progressive MS experience a steady and generally irreversible worsening of their symptoms. Most existing therapies are ineffective once people have moved to this stage of the condition, so our findings demonstrate how important it is to take a proactive approach to treating MS.”

One of the study leads, Associate Professor Tomas Kalincik, head of the MS Service at The Royal Melbourne Hospital and CORe at the University of Melbourne, observed that the results are reassuring for neurologists and patients with MS.

"This study shows that the therapies they have been treated with for many years, significantly improve the quality of their lives over the long-term," he said.

The study, “Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis” was published in the journal JAMA.