Interferons helped SPMS in small study
Submitted by art on Mon, 2005-11-07 08:54.
This study followed 21 people with Secondary Progressive MS (SPMS) for 12 months while on Interferon-Beta and then for 12 months once they stopped. They found that measures of progression and MRI results did not worsen while on drug, but did once they stopped.
interferon
I think this story will worsen. After having been on beta-1a (44mcg) as a person with RRMS for 7 years, I still drove before going off it. I went off it for 7 months. After that, I had converted to SPMS. I was tried on Copaxone for a year. Had Mitoxantrone for six months, got weaker and thinner, and I am now on no disease-modifying drugs (there are no more approved in Canada). I bought a wheelchair. I am now improving due to exercise and eating changes.
It may sound like self-pity, but I believe withdrawal from interferon use may hasten conversion to SPMS. My conversion was fairly sudden after my long use of interferon during which a lot less progression occurred. If I didn't believe it helped RRMS I wouldn't have been on it. But after you worsen to SPMS, it is said to no longer be working. I do not believe people with SPMS suddenly have a different disease. It stands to reason (to me) that it would help SPMS, but what are the implications for people with RRMS who stop taking it?
Specifically, will discontinuation cause them to worsen more quickly than they were before they took it? After my experience, is it even ethical to test the theory? I think a lot of people with SPMS, who are still able to stay on interferon, have benefitted from the hard sacrifices of these study controls. I thank those people for their unselfishness.
Re:interferon
"The analysis of interferon-beta trials also raises an uncomfortable question regarding its therapeutic efficacy in decreasing relapses and enhancing lesions being compromised by continued brain-tissue loss. In the natural history of MS, the transition from relapsing-remitting to secondary-progressive phase of the disease is similarly associated with progressive accumulation of disability and fewer relapses. - - - Treatment with interferon beta may lower relapse rates and decrease the volumes of new or enhancing lesions but it does not have any consistent therapeutic effect on neurodegeneration—and hence long-term disability—in patients with MS. We must ask if some patients given interferon beta experience a higher disability in the later years because of a possibility of accelerated brain tissue loss that would clearly outweigh any marginal benefit from relapse reduction in the early years. We need to look beyond the present to care for our patients in the future." (The Lancet Neurology vol 4 April 2005 p. 208-209)