Early Therapy May Alter Multiple Sclerosis

Reduced Risk of Second Attack Seen in Israeli Study

From the WebMD Archives

Oct. 12, 2004 -- The unpredictable nature of multiple sclerosis leaves many people vulnerable to this disease, yet a new study suggests that very early therapy may alter its course.

A new Israeli study shows that immune therapy given after an initial attack of what appears to be multiple sclerosis (MS) in its early stages may slow the disease and protect the body from nerve damage.

Multiple sclerosis is a chronic, inflammatory disease affecting the brain and spinal cord. The cause is related to damage to myelin, the tissue sheathing the nerve cells in the brain and spinal cord. As a result, people with multiple sclerosis can experience problems with muscle control and strength, vision, balance, sensation, mental function, fatigue, and urinary tract function.

Many cases develop gradually. In some patients, the disease has an on-again, off-again pattern called relapsing-remitting MS, in which symptoms flare up and then disappear.

Previous studies have found that the length of time between the first and second occurrences of multiple sclerosis symptoms can be an important predictor of the disease's progress. The longer the duration between first and second occurrences, the better.

Immunoglobulin Reduces Duration

In the study, Anat Achiron, MD, PhD, of the Multiple Sclerosis Center at Sheba Medical Center in Tel-Hashomer, Israel, and colleagues tested an approach using an immune therapy called intravenous immunoglobulin.

The researchers wanted to see if intravenous immunoglobulin therapy bought more time for people who had had their first multiple sclerosis event.

They recruited 91 participants, randomly assigning half the group to receive immunoglobulin intravenously once every six weeks for a year. The rest received a placebo.

Participants had MRI images taken at the study's beginning and end. They also had neurological tests and physical exams every three months during the experiment.

Immunoglobulin "significantly lowered" the occurrence of a second attack and reduced inflammation and disease activity, say the researchers in the October issue of the journal Archives of Neurology.

Since a second attack is required for definitive diagnosis of MS, immunoglobulin "reduced the probability of reaching a definitive diagnosis of MS by 48% within the first year from onset," they say.

Overall, side effects were few and included headache, rash, nausea, and tightness in the chest. All side effects disappeared within 24 hours.

Intravenous immunoglobulin could be considered a treatment option for patients who have had one multiple sclerosis episode, say the researchers.

The treatment could be used by patients who can't tolerate other medications or who wish to become pregnant, say Achiron and colleagues.

Show Sources

SOURCES: Achiron, A. Archives of Neurology, October 2004; vol 61: pp 1515-1520. News release, JAMA/Archives. WebMD Medical Reference from Healthwise: "Multiple Sclerosis: Topic Overview."
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