Against multiple sclerosis, early treatment is key.

Image credits U.S. Air Force / Staff Sgt. Alexandre Montes.

A new study led by researchers from the Royal Melbourne Hospital and the University of Melbourne found that early treatment — particularly within five years of onset — is effective in delaying the progress of multiple sclerosis (MS). Such measures can delay progress to the second stage of the disease, which is characterized by progressive levels of physical and mental disability.

The study is the first to provide evidence that currently-available treatments can delay the progress of MS.

Preventive measures

The study used data from 1555 patients from 68 neurological clinics across 21 countries. Tomas Kalincik, Associate professor at the University of Melbourne and study co-lead author, says that the findings showcase how important proactive treatment is in dealing with MS. The research focused on patients with relapsing-remitting MS commencing or clinical monitoring between 1988-2012 with minimum 4 years’ follow-up.

“People who converted from relapsing MS to secondary progressive MS experience gradual and mostly irreversible worsening of disability,” he explained.

“Most of the therapies that we use to treat MS have no effect once people have converted to secondary progressive MS.”

Currently, more than 23,000 Australians are living with MS, the paper explains. The conversion to the secondary progressive stage of MS is characterized by worsening of physical and mental capacity. The team, therefore, argues that preventive treatment is a very powerful tool in improving the quality of life for MS patients.

“This study shows that the therapies they have been treated with for many years, significantly improve the quality of their lives over the long-term,” Kalincik said.

Patients included in the study that underwent “initial treatment with fingolimod, natalizumab, or alemtuzumab” had a reduced risk of developing second-stage MS over a 5-year period. All drugs studied here showed different results, although all were effective. For example, patients initially treated with glatiramer acetate or interferon beta had a 12% chance of conversion to secondary MS, compared to 27% for the control group. Early fingolimod treatment reduced this risk to 7% compared to 32% for controls, and natalizumab to 19% compared to 38% for controls.

Kalincik said he hopes the results will reassure both neurologists and patients with MS that the disease can be managed, and the worst of it avoided — if treatment is started in time. The findings should also help point to the optimal path for treatment, the study adds.

The paper “Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis” has been published in the Journal of the American Medical Association.