Early Multiple Sclerosis Treatment May Improve Long-Term Outcomes

Starting multiple sclerosis (MS) treatment upon the first signs of the disease was associated with prolonging the time before MS is definitively diagnosed, a recent study found.

The study, published in Neurology, involved participants who experienced an initial episode suggestive of MS, including balance issues, numbness, and vision problems, and an MRI that showed signs of possible MS.

“Not much research has been done on how starting treatments this early affects the long-term course of the disease,” said study author Ludwig Kappos, MD. “Our study adds to the evidence supporting treatment at the earliest sign of the disease and indicates that early treatment has a long-lasting effect on disease activity.”

For the long-term study, 468 patients were randomized to receive either early treatment with interferon beta-1b or a placebo. Once the participants were diagnosed with MS, or after 2 years, the group given placebo could switch to interferon beta-1b or a different drug.

After 11 years, 278 people still participating in the study were reevaluated. This included 167 participants in the early group, and 111 people in the delayed group.

The results of the study showed that 33% of participants who received early treatment were less likely to be diagnosed with MS than those who received delayed treatment. Furthermore, participants in the early treatment group also had more time before their first relapse of MS compared with individuals in the delayed treatment group, with 1888 days compared with 931 days, respectively.

Researchers also found that the early group had a lower overall yearly relapse rate 0.21 versus 0.26 for the delayed group, a 19% difference. Study authors noted there was no difference between the 2 groups in tests that measured overall disability, or in MRI scans that measured the amount of damage caused by the disease.

“Overall, early treatment appears to have a benefit on relapses, especially early in the disease, but limited effects on other outcome measures, including outcomes reported by patients,” said researcher Brian C. Healy, PhD, who wrote an accompanying editorial.

Authors noted that some limitations to the study included that participants and researchers did not learn which participants received the drug and which received the placebo until after testing in the fifth year. Furthermore, after the placebo-control phase of the study, all the participants received treatment, meaning there was no untreated control group left after that point.