Do Multiple Sclerosis Drugs Work?

A recent study is reporting that the Multiple Sclerosis (MS) drugs widely used to reduce relapses or MS flare-ups, specifically interferon beta, do not slow progression toward disability.  The study, published in the Journal of the American Medical Association (JAMA) reported:

“Patients treated with interferon beta were no less likely than untreated patients to progress to the point where they required a cane to walk, which is a benchmark measure of disease progression.”

The study acknowledges their finding contradict the findings of an earlier Italian study as well as studies from the pharmaceutical companies that manufacture these disease modifying drugs for MS patients. While the JAMA study is far from conclusive in determining the effectiveness of MS drug therapies, one of the author’s statements may be the most beneficial for neurologists and patients battling this disease.

“Because of the wide variability in MS, it is likely that these drugs do delay disease progression in some patients, but not in others,” Coetzee says. “The problem is that we currently have no tools to help us identify patients who will and will not respond.”

This statement provides insight into one of guiding principles that I have been using for decades to treat MS patients at our Multiple Sclerosis Center.  In a previous video blog, Multiple Sclerosis is a Tough Disease, I stressed the importance of aggressively following our MS patients to see if the treatment plan is working or not.

Additionally, The Multiple Sclerosis Journal just published a study evaluating the relationship between Obstructive Sleep Apnea (OSA) to fatigue and sleepiness in MS patients. Among the findings in this study, OSA was frequent in MS patients (twice the rate) and OSA was associated with fatigue in the MS population.

This finding mirrors the results of our study from many years ago.  MidAmerica Neuroscience Institute presented High Prevalence of Sleep Disorders in Multiple Sclerosis at the Consortium of Multiple Sclerosis Centers (CMSC) meeting in 2004.

I have mixed feelings as I consider these two studies.  It is somewhat disappointing that this knowledge is just now making it into the medical journals.  However, I am comforted by the fact that the model of our comprehensive MS Center – incorporating Clinical Research Trials, Physical Therapy, Accredited Sleep Center, Electrophysiology Lab and Basic Science Research – will continue to stay ahead-of-the-curve and provide our MS patients with the very best care available.

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