Research news - April 2008

Way Ahead 2008;12(2):4

Cannabis spray reaches more patients
People with MS suffer untreated anxiety and depression
Time of beta-interferon injections determines tolerability
Genetics may explain response to beta interferons

Cannabis spray reaches more patients

Recent media reports suggest that Scottish doctors have grown impatient of waiting for the cannabis-based drug Sativex to be licensed, and many are prescribing it to multiple sclerosis patients to relieve their pain.

A recent study published in the journal Pain concluded that the drug demonstrated significant superiority over placebo in treating patients with peripheral neuropathic pain. Another phase III trial of Sativex has recently got underway to assess the effect of Sativex on MS spasticity.

Consolidating these positive developments, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) published a Public Information Report on Sativex. The report acknowledges the 1200 patients using Sativex in the UK and provides potential subscribers with information on the MHRA's assessment criteria.

Initial results of the spasticity trial are expected towards the end of 2008 and may determine whether GW Pharma resubmits an application for UK licensing.

Nurmikko T, Serpell M, et al.
Sativex successfully treats neuropathic pain characterised by allodynia: A randomised, double-blind, placebo-controlled clinical trial.
Pain 2007; 133(1-3)210-220.

Back to top

People with MS suffer untreated anxiety and depression

A recent study investigating the prevalence of depression and anxiety amongst people with MS indicates that these symptoms are experienced in a significantly higher proportion than that of the general population.

140 MS patients from Eastern Norway underwent neuropsychiatric and clinical examinations, registered symptoms of depression and anxiety, and provided information about any help they had sought for depression. A total of 31.4% of patients reported symptoms of depression, whilst 19.35% reported anxiety. Fatigue and a younger age at onset correlated with symptoms of depression whilst fatigue, pain, lower Expanded Disability Status Scale score and younger age at onset correlated with symptoms of anxiety. Worryingly, 18.2% of untreated patients with symptoms expressed the need for treatment. The study concluded that more emphasis on depression and anxiety amongst people with MS is needed in order to establish appropriate treatments.

Beiske AG, Svensson I, et al.
Depression and anxiety amongst multiple sclerosis patients.
Eur J Neurol 2008;15(3):239-245.

Back to top

Time of beta-interferon injections determines tolerability

Researchers have suggested that the systemic side effects of interferon-beta therapy experienced by many MS patients may depend on the time at which they routinely inject. Sixteen people with relapsing-remitting MS were divided between a morning group - receiving injections at 8:00am; and an evening group - receiving injections at 6.00pm. Patients in both groups were monitored for levels of several hormones that are know to regulate the immune system as well as any clinical side effects experienced over the nine hours following injection. The evening group experienced more intense clinical side effects which correlated with increased temperature and a quicker increase in levels of plasma hormones. The study investigators reason that the time of beta-interferon is injected has implications on the tolerability and effectiveness of the therapy.

Kümpfel T, Schwan M, Pollmächer Th, et al.
Time of interferon-B a injection and duration of treatment affect clinical side effects and acute changes of plasma hormone and cytokine levels in multiple sclerosis patients.
Mult Scler 2007; 13(9): 1138-1145.

Back to top

Genetics may explain response to beta interferons

A recent study suggested that genetic factors may determine whether a person with relapsing-remitting MS responds positively to interferon beta therapy. The researchers claimed that although interferon beta therapy is widely used in the treatment of MS, up to 50% of the patients receiving it continue to suffer relapses and worsening of symptoms. A cohort of 206 patients with RRMS, were monitored for two years following the start of beta interferon therapy. Response to therapy was gauged by measuring their respective levels of disability, assessed four times per year. Over the two year duration of the study, 99 patients responded positively to the therapy, while the remaining 107 showed no response. The patients DNA was analyzed and genetic differences correlating with the respective responsive and non-responsive groups were identified. The findings represent an advance in our understanding of how drugs work in the body and support further investigation into the potential role of genes as predictors of response to different therapies.

Byun E, Caillier SJ, Montalban X, et al.
Genome-wide pharmacogenomic analysis of the response to interferon beta therapy in multiple sclerosis.
Arch Neurol 2008;65(3):337-344.

Back to top

Return