Research supports quick initiation of MS care

The challenge now is to determine how to detect the disease accurately at early stages.

By Victoria Stagg Elliott, AMNews staff. Aug. 27, 2007.

When it comes to multiple sclerosis, early initiation of therapy, when possible, appears to be very effective. Also, researchers have discovered two genes that confer additional risk for the development of MS. These alleles have a role in other autoimmune diseases and are expected to open the door to new treatment targets, according to a handful of papers published in July and August.

"It's a very exciting time for MS research," said Stephen Hauser, MD, professor and chair of neurology at the University of California, San Francisco.

A paper in the Aug. 4 Lancet found that patients who started every-other-day injections of interferon beta-1b soon after the first signs of the disease were less likely to progress to full-blown MS or to develop additional disability within three years.

"Early treatment ... at the time of the first event highly suggestive of MS makes a difference for patients who have additional evidence of clinically silent lesions in the initial MRI," said Dr. Ludwig Kappos, lead author and acting chair of neurology at University Hospital in Basel, Switzerland.

This study is the latest to suggest that sooner is better, but experts say there are many barriers to starting treatment at the disease's earliest stages. Patients who may not feel that sick may be hesitant to begin an injectable medication, particularly since the course of MS can be unpredictable and vary widely from crippling to benign.

"It really depends very much on the patient," said Elizabeth Morrison, MD, MSEd, associate professor of clinical family medicine at the University of California, Irvine, who has researched wellness issues for those with this disease. "Some patients have one attack with a symptom that is very concerning to them, such as temporary or permanent loss of vision. Then they're willing to consider treatment. Some want to wait until they've had other symptoms. We need to respect how patients feel about that."