MS research update - 11 June 2010
- Methotrexate shows potential in treating progressive MS
- Rituximab shows promise as an add-on treatment in relapsing remitting MS
Methotrexate shows potential in treating progressive MS
Methotrexate is an immunosuppressant drug used in the treatment of cancer, arthritis and psoriasis. In MS, it has also been shown to have an effect on reducing relapse rates and slowing progression in the short term.
This study investigated the effects of using intrathecal (given as an injection into the spinal canal) methotrexate in 121 people with secondary or primary progressive MS. Study participants received up to 8 treatments given every 8 to 11 weeks.
In 87 people with secondary progressive MS, 89% of people showed stable or improved EDSS scores (a disability rating scale that is used by clinicians to rate levels of impairment and mobility). Of 34 people with primary progressive MS, 82% showed stable EDSS scores.
The results of this study suggest that intrathecal methotrexate may benefit people with progressive forms of MS. Larger studies are needed to confirm these positive results.
Sadiq SA, Simon EV, Puccio LM.
Intrathecal methotrexate treatment in multiple sclerosis
Journal of Neurology 2010; Epub ahead of print.
Medline abstract
Rituximab shows promise as an add-on treatment in relapsing remitting MS
Rituximab is a monoclonal antibody licensed to treat leukaemia and non-Hodgkins lymphoma. It is known to reduce the number of B-cells in the immune system and is being studied as a treatment for MS.
This study investigated the effects of adding rituximab to standard injectable disease modifying treatments in people who show signs of active disease on MRI. Thirty people who had experienced a relapse in the last 18 months despite use of an injectable disease modifying treatment received four cycles of rituximab by intravenous infusion over a 52 week study period.
MRI scans were conducted before, during, and after treatment with rituximab. After treatment with rituximab, 74% of MRI scans were free of active areas of inflammation compared with 26% seen before treatment with rituximab. The authors conclude that rituximab remains a potential option for treatment of people with relapsing remitting MS who show inadequate response to standard licensed injectable drugs.
Naismith RT, Piccio L, Lyons JA, et al.
Rituximab add-on therapy for breakthrough relapsing multiple sclerosis: A 52-week phase II trial
Neurology 2010; 74(23):1860-67.
Medline abstract