MS research update - 22 January 2010
- MRI scans show greater MS damage occurs in African Americans
- Study points to factors that increase risk of depression in MS
- Oral drug fingolimod proves more effective than interferon beta-1a in reducing MS relapses
- Oral drug cladribine significantly reduces relapses
MRI scans show greater MS damage occurs in African Americans
Previous research has shown that African American people with MS have more rapid progression and often a less successful response to disease modifying drug therapies. The present study investigated whether any differences could be seen between the MRI scans of African American people with MS and white American people with MS.
567 people with MS took part in the study, the majority of whom were receiving disease modifying drug therapy. The MRI findings showed greater tissue damage and a greater number of brain lesions in African Americans. The findings of this MRI study confirm previous research which has suggested that race is a factor in how MS evolves.
Weinstock-Guttman, Ramanathan M, Hashmi K, et al.
Increased tissue damage and lesion volumes in African Americans with multiple sclerosis.
Acta Neurologica Scandinavica 2010; Epub ahead of print.
Medline abstract
Study points to factors that increase risk of depression in MS
Depression is common in the general population, but research has indicated that people living with long-term conditions such as MS, are at greater risk of experiencing depression. The present study sought to determine what factors make people with MS more susceptible to depression.
115 people with MS took part in the study and completed questionnaires that focused on aspects of depression, anxiety, coping, self-esteem and social support structures. The results of the study indicate that an individual's levels of: physical disability, trait anxiety (a term used to describe an individual's tendency to be anxious), alexithymia (the inability to express emotions verbally) and satisfaction with social support, all influenced their susceptibility to depression.
Gay MC, Vrignaud P, Garitte C, et al.
Predictors of depression in multiple sclerosis patients.
Acta Neurologica Scandinavica 2010; Epub ahead of print.
Medline abstract
Oral drug fingolimod proves more effective than interferon beta-1a in reducing MS relapses
The findings of two studies into the effectiveness of fingolimod (FTY720), an oral drug in development for the treatment of MS were published this week. One of the studies compared two different daily doses of oral fingolimod against a daily placebo drug and one of the studies compared the two different daily doses of oral fingolimod against interferon beta-1a.
1,033 people with relapsing remitting MS in 22 countries took part in the placebo controlled study and received one of two doses of fingolimod or placebo over two years. The results show that fingolimod reduced the relapse rate by 54% for the lower dose (0.5 mg) and by 60% for the higher dose (1.25 mg) compared to placebo. The reduction of progression of disability was 30% and 32% respectively compared to placebo.
1,153 people with relapsing remitting MS completed the second study comparing fingolimod against interferon beta-1a over one year. 80 to 83% of the fingolimod groups remained relapse-free compared with 69% of those on interferon beta-1a.
Fingolimod 0.5mg was submitted to the drug regulators for licensing in Europe and the USA at the end of 2009 and the National Institute for Health and Clinical Excellence (NICE) has already suggested that it will include fingolimod in the next round of assessments.
Kappos L, Radue EW, O'Connor P, et al.
A placebo controlled trial of oral fingolimod in relapsing multiple sclerosis.
New England Journal of Medicine 2010; 362(5):1-15.
Full article
Cohen JA, Barkhof F, Giancarlo C, et al.
Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis.
New England Journal of Medicine 2010; Epub ahead of print.
Full article
Oral drug cladribine significantly reduces relapses
Promising findings of a study into the effectiveness of another oral drug in development for the treatment of MS, cladribine, were also published this week The two year study recruited more than 1,300 people with relapsing remitting MS and randomly allocated them to one of three groups; one group received a lower overall dose of cladribine; one group received a higher overall dose of cladribine; and a third group received a placebo (dummy) drug.
A 55-58% reduction in yearly relapse rates was seen in the two cladribine groups compared to the placebo group.
The drug manufacturer has submitted cladribine for licensing in Europe and the US and the UK's National Institute for Health and Clinical Excellence (NICE) has indicated that it will include cladribine in its next round of assessments.
Giovannoni G, Comi G, Cook S, et al.
A placebo-controlled trial of oral cladribine for relapsing multiple sclerosis.
New England Journal of Medicine 2010; Epub ahead of print.
Full article