Topline
Researchers on Wednesday said an existing and approved drug might be able to stop multiple sclerosis in its tracks before people experience any symptoms of the disease, preliminary findings that offer a very early ray of hope that patients could one day be spared the worst parts of the devastating and incurable neurological condition or even avoid it entirely.
Key Facts
Early research, which was presented by Frenay at the American Academy of Neurology’s 75th Annual Meeting on Wednesday, suggests teriflunomide, a drug already in use to reduce the number and severity of multiple sclerosis relapses, can also stall the onset of symptoms in those with scans showing early signs of the disease.
Accounting for other factors that can affect the chances of developing symptoms, the researchers found that people taking a daily dose of the drug, teriflunomide, had a 72% lower risk of experiencing their first symptoms compared to those taking an inactive placebo.
Multiple sclerosis, often known as MS, is a degenerative and potentially disabling neurological condition thought to be caused by the immune system mistakenly attacking the protective layer that surrounds nerve cells, which disrupts signals to and from the brain and can trigger symptoms including dizziness, vision problems, paralysis and muscle weakness.
While there is no single diagnostic test for MS, MRI scans can sometimes reveal a hallmark pattern of scarring in the brain, spinal cord and other parts of the nervous system (in plain English, multiple sclerosis means multiple or many scars).
Signs of similar damage are sometimes found in the scans of people who do not have any symptoms of multiple sclerosis—termed radiologically isolated syndrome—and many will later go on to develop MS, said Dr. Christine Lebrun Frenay, of France’s University Hospital of Nice.
Lebrun Frenay said the results, which have not been published or peer reviewed and are based on a study of 89 people with radiologically isolated syndrome followed over two years, signal early promise for delaying nerve damage in MS patients, “which decreases the risk of permanent neurologic impairment and debilitating symptoms.”
What To Watch For
With more people having brain scans for reasons like headaches or head injuries, Lebrun Frenay said “more of these cases are being discovered, and many of these people go on to develop MS.” While the findings must be replicated in larger groups of people, such detection could make it possible to stave off MS in many people should the drug’s promise pan out. Lebrun Frenay said it is important clinicians are “cautious when using MRI,” however, so as to avoid misdiagnosing people with MS. French pharma giant Sanofi, which makes teriflunomide and supported the study, did not immediately respond to Forbes’ request for comment on the findings or its future plans for the drug.
Key Background
Multiple sclerosis is the most common disabling neurological condition of young adults, according to the National Institute of Neurological Disorders and Stroke, with symptoms typically starting between the ages of 20 and 40 years. The precise cause of the disease is not known but experts generally believe it involves the body’s immune system wrongly attacking nerve cells. Environment, genetics and exposure to viruses like Epstein-Barr are all thought to play a role and women are more often affected (estimates vary but MS seems to occur between two to four times more often in women than men). The course of the disease is different for each person but symptoms range from muscle weakness, tingling and dizziness in the early stages to mental and physical fatigue, mood changes, cognitive problems and paralysis in the later stages. Many people living with MS will experience transient symptom attacks or flare-ups, where new symptoms can emerge or old ones worsen, followed by a period of remission. There is no cure but there are treatments that can help reduce the number of relapses and reduce their severity.
Big Number
1 million. That’s how many people are estimated to be living with multiple sclerosis in the U.S., according to a 2019 study funded by the National Multiple Sclerosis Society. A different study estimates a total of 2.8 million people live with the condition worldwide. Data is patchy, however, and the true burden of the disease could be substantially higher and the number of people living with MS has been rising in recent years.
Further Reading
Moderna Starts Human Trials Of mRNA Vaccine For Virus That Likely Causes Multiple Sclerosis (Forbes)
Global spread of autoimmune disease blamed on western diet (Guardian)
The Medicine Is a Miracle, but Only if You Can Afford It (NYT)