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Sunday
Analysis: Early MS therapy delays decline
Analysis: Early MS therapy delays decline
By ED SUSMANBOSTON, May 2 (UPI) -- The risk that a multiple sclerosis patient will decline in function can be dramatically reduced if that patient is treated at the first sign of an attack, U.S. researchers said Tuesday.
"For the first time we are showing that treating people early (means) not only preventing attacks, but significantly delaying disability," Mark Freedman, director of the Multiple Sclerosis Unit at the University of Ottawa, told United Press International.
In a presentation Tuesday at the 59th annual meeting of the American Academy of Neurology in Boston, Freedman said that treating patients early in the disease course with interferon beta-1b -- sold as Betaseron and a standard-of-care drug for MS for two decades -- resulted in:
-- a 40-percent reduction in the risk of progression as measured by standard on disability tests. "About 24 percent of placebo patients showed disease progression on the Expanded Disability Scale Score compared with 16 percent of patients on Betaseron," Freedman told UPI.
-- a 41-percent reduction in the risk that patients will have a second MS attack within three years. "About 51.7 percent of patients who were started on placebo suffered a multiple sclerosis confirming attack within three years of the study compared with 36 percent of people on Betaseron," he said.
Traditionally, doctors have waited until a second "confirmatory" MS exacerbation occurs before starting treatment -- but the BENEFIT (Betaseron in Newly Emerging Multiple Sclerosis for Initial Treatment) trial challenges that theory.
"I was one of those skeptics who told patients who had one multiple sclerosis attack that we could afford to wait," Freedman admitted, but now he said that it appears early treatment does benefit patients.
His study involved 468 patients, originally assigning 261 patients to Betaseron and 157 to placebo. After three years 249 patients remained on the interferon treatment and 143 patients were still on placebo.
Freedman said that patients who had second attacks and then began interferon therapy did not catch up to the patients who began with active treatment after the first signs of multiple sclerosis. "The differences between these groups continue to widen," he said.
"Some patients have already developed significant neurological damage when they first present with signs of multiple sclerosis, which can lead to accumulated disability later in life," Freedman said.
"This is a truly novel finding that has not yet been demonstrated for any other immunomodulatory multiple sclerosis treatment, and underscores the urgent need to treat patients early, rather than waiting for further signs of disease to develop," he added. "Physicians and patients should consider these unprecedented findings when making treatment decisions."
Freedman said patients who have a first attack have an 80-percent chance of having a second attack within two years. "Immediate treatment can prevent or delay the chance of progression," he said.
"We now have very persuasive data that treating early is a better course of action," said Gary Birnbaum, director of the Multiple Sclerosis Treatment and Research Center at the Minneapolis Clinic of Neurology in Golden Valley and a board-certified neurologist.
"The new study shows us that the placebo patients never quite catch up to the patients who are treated after the first attack. I think the general consensus now is that patients should be treated as soon as they meet the most recent criteria for multiple sclerosis."
He said that neurologists using a combination of clinical examination and imaging data can make an accurate diagnosis after that initial attack.
By ED SUSMANBOSTON, May 2 (UPI) -- The risk that a multiple sclerosis patient will decline in function can be dramatically reduced if that patient is treated at the first sign of an attack, U.S. researchers said Tuesday.
"For the first time we are showing that treating people early (means) not only preventing attacks, but significantly delaying disability," Mark Freedman, director of the Multiple Sclerosis Unit at the University of Ottawa, told United Press International.
In a presentation Tuesday at the 59th annual meeting of the American Academy of Neurology in Boston, Freedman said that treating patients early in the disease course with interferon beta-1b -- sold as Betaseron and a standard-of-care drug for MS for two decades -- resulted in:
-- a 40-percent reduction in the risk of progression as measured by standard on disability tests. "About 24 percent of placebo patients showed disease progression on the Expanded Disability Scale Score compared with 16 percent of patients on Betaseron," Freedman told UPI.
-- a 41-percent reduction in the risk that patients will have a second MS attack within three years. "About 51.7 percent of patients who were started on placebo suffered a multiple sclerosis confirming attack within three years of the study compared with 36 percent of people on Betaseron," he said.
Traditionally, doctors have waited until a second "confirmatory" MS exacerbation occurs before starting treatment -- but the BENEFIT (Betaseron in Newly Emerging Multiple Sclerosis for Initial Treatment) trial challenges that theory.
"I was one of those skeptics who told patients who had one multiple sclerosis attack that we could afford to wait," Freedman admitted, but now he said that it appears early treatment does benefit patients.
His study involved 468 patients, originally assigning 261 patients to Betaseron and 157 to placebo. After three years 249 patients remained on the interferon treatment and 143 patients were still on placebo.
Freedman said that patients who had second attacks and then began interferon therapy did not catch up to the patients who began with active treatment after the first signs of multiple sclerosis. "The differences between these groups continue to widen," he said.
"Some patients have already developed significant neurological damage when they first present with signs of multiple sclerosis, which can lead to accumulated disability later in life," Freedman said.
"This is a truly novel finding that has not yet been demonstrated for any other immunomodulatory multiple sclerosis treatment, and underscores the urgent need to treat patients early, rather than waiting for further signs of disease to develop," he added. "Physicians and patients should consider these unprecedented findings when making treatment decisions."
Freedman said patients who have a first attack have an 80-percent chance of having a second attack within two years. "Immediate treatment can prevent or delay the chance of progression," he said.
"We now have very persuasive data that treating early is a better course of action," said Gary Birnbaum, director of the Multiple Sclerosis Treatment and Research Center at the Minneapolis Clinic of Neurology in Golden Valley and a board-certified neurologist.
"The new study shows us that the placebo patients never quite catch up to the patients who are treated after the first attack. I think the general consensus now is that patients should be treated as soon as they meet the most recent criteria for multiple sclerosis."
He said that neurologists using a combination of clinical examination and imaging data can make an accurate diagnosis after that initial attack.