MS research update - 12 February 2010
- Persistence of neutralising antibodies after stopping treatment linked to relapses and disability progression
- Anxiety and poor memory linked to poor adherence to disease modifying drugs
- Younger children with MS have a distinct cerebrospinal fluid profile
Persistence of neutralising antibodies after stopping treatment linked to relapses and disability progression
Antibodies are proteins produced by the immune system to fight foreign substances such as infections. As with drugs that are used in some other conditions such as diabetes, use of interferon beta over a long period of time may result in the production of what are known as 'neutralising antibodies'. These antibodies are thought to reduce the effectiveness of the drug but have not previously been linked to any long-term risks.
The present study investigated the persistence of neutralising antibodies in 71 people with relapsing remitting multiple sclerosis who had ceased treatment with interferon beta about two years previous, a number of whom were currently receiving a different disease modifying drug. Data relating to the number of yearly relapses and disability progression experienced by each study participant before and two years after stopping interferon treatment was also compared.
Of the 71 people tested, almost a quarter tested positive for the presence of neutralising antibodies to interferon beta and 15% had what is regarded as a high level of neutralising antibodies. The people who had higher levels of neutralising antibodies showed the greatest increase in annual relapse rates and disability progression after discontinuing treatment with interferon beta and were more likely to have switched to a more aggressive disease modifying drug.
The study authors acknowledge the limitations of the study and suggest that further research is needed to confirm these findings.
Van der Voort LF, Gilli F, Berrtlotto A.
Clinical effect of neutralizing antibodies to interferon beta that persist long after cessation of therapy for multiple sclerosis.
Archives of Neurology 2010; [Epub ahead of print]
Medline abstract
Anxiety and poor memory linked to poor adherence to disease modifying drugs
Adherence to treatment is of great importance where long-term treatments are concerned as their effectiveness is usually only seen if they are taken correctly over a period of some time.
People with MS cite many different reasons for failing to adhere to the self-injected disease modifying drugs, but the present study investigated whether there is any association between personality traits, mood disorders, and cognition problems and poor adherence to the self-injected disease modifying drugs that are used in MS.
A number of people with MS on disease modifying drugs underwent a series of assessments to identify specific mood disorders, personality traits, and cognitive problems. They were asked to use a medication diary and an electronic monitoring device that recorded needle disposals for a period of eight weeks.
The findings of the study suggest that people with mood or anxiety disorders were almost five times as likely as the people without mood disorders to show poor adherence to disease modifying drugs. Poor adherence was also associated with memory problems, depression and low conscientiousness.
Bruce JM, Hancock LM, Arnett P.
Treatment adherence in multiple sclerosis: association with emotional status, personality, and cognition.
Journal of Behavioural Medicine 2010; [Epub ahead of print]
Medline abstract
Younger children with MS have a distinct cerebrospinal fluid profile
Analysis of cerebrospinal fluid (CSF) - the fluid that fills and protects cavities in the brain and spinal cord and may be extracted during a lumbar puncture - is sometimes used to confirm a diagnosis of multiple sclerosis. The presence of specific laboratory markers in an individual's CSF may be suggestive of abnormal immune activity.
Based on the data held by 6 pediatric MS centres, the present study sought to determine whether there was any distinct difference between the CSF profiles of early onset pediatric MS (below 11 years of age) and later onset pediatric MS (over 11 but below 18 years of age).
The study authors found distinct differences between the markers present in the CSF of early onset pediatric MS compared with later onset pediatric MS and hypothesise that this may be accounted for by changes in the immune system that occur with age.
Chabas D, Ness J, Belman A, et al.
Younger children with MS have a distinct CSF inflammatory profile at disease onset.
Neurology 2010; 4(5): 399-405
Medline abstract