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A new combination treatment regime, for people with aggressive forms of MS, is offering new hope to a group of people who would otherwise be at high risk of early disability, according to British research.
The treatment regime, consisting of a limited course of mitoxantrone (an immunosuppressant normally used to treat cancer) followed by long-term glatiramer acetate (Copaxone® - one of two classes of disease modifying drugs for use in relapsing-remitting multiple sclerosis), has proven so successful in this early trial that a full controlled study is now being initiated at 10 centres across the UK to examine the combination further.
In this ‘open’ trial the combination was found to provide a rapid and sustained suppression of relapses in people with MS experiencing frequent, recurrent and disabling attacks (90% reduction in annualised relapse rate maintained, to date, for a mean of 36 months). It was also shown to improve, or at least stabilise, existing levels of disability in the 27 people who had extremely active forms of the disease. Follow up in early patients now extends to over 5 years.
The patients treated with this new protocol, developed by a research team at the UK’s Walton Centre for Neurology and Neurosurgery in Liverpool, had all been diagnosed with Relapsing Remitting MS for less than 5 years and showed clear signs that their disease was likely to progress quickly producing early and severe disability.
Dr Mike Boggild, Consultant Neurologist at the Walton Centre and principal investigator of this research commented: “This novel treatment regime has proved remarkably effective in a group of patients with early MS and a poor prognosis. Though there are certain risks, associated particularly with the use of Mitoxantrone, we have been able to limit these by using this agent for just a short ‘induction’ period and, balanced against the high risk of early disability for these patients, the outcomes we have seen appear to justify this approach. The effect is so striking that we suspect the two drugs may be acting synergistically.â€
Mitoxantrone, the first immunosuppressant to be approved by the United States Food and Drug Administration (FDA) for use in MS, has previously been shown in randomised controlled studies in the US to reduce relapses in MS, but due to its potential toxicity, its use is limited. Previous attempts to extend its effectiveness with subsequent use of interferon-beta have been disappointing, so researchers at the Walton Centre decided to use the alternative class of disease modifying drug, glatiramer acetate (Copaxone®).
Here’s an short and reliable summary about stem cells and their role in treating MS. You can download a PDF or read the full document online at: http://www.regenecell.com/article-multiple-sclerosis-status.htm
The article discusses what MS is, the way forward for using stem cells as well as current developments in using stem cell transplants for treating MS.
Scotland has the highest rate of MS in the world, with an estimated 10,500 people living with MS. Across the UK about one in every 800 people has MS, but in Scotland the figure is estimated at one in 500 (in NZ it is thought to be one in every 1,000).
It's far more common there and in countries like Canada, Scandinavia and Ireland than it is in countries nearer the equator. MS can often quite literally be mapped along lines of latitude.
It's more common in higher latitudes but confusingly that's not the only factor in explaining why and where MS occurs.
You can't catch MS - it's not contagious - and you can't directly inherit MS, but genetic factors do seem to play some kind of role.
Another theory is that it could be down to a virus that triggers the onset of MS.
Diet and climate could have something to do with it but basically no-one has a definitive answer.
Another thing they don't know is exactly how many people have MS in Scotland.
But that looks set to change with the development of a register of everyone who has the condition. The MS Society in Scotland has begun setting up just such a database along with the NHS in Scotland to find out exactly how many people have MS.
Keeping a register will greatly help research into MS, as will a brand new centre opening in Edinburgh - the MS Society Edinburgh University Translational Research centre.
An MS register has already been established in Canada. For a quarter of a century clinicians there have been gathering details of just about everyone diagnosed with MS - and keeping a national register.
A national MS Prevalence Study is also due for completion soon in New Zealand (see www.msnz.org.nz/research/prevalence.html )