Early treatment does delay MS disease progression, new study confirms

Early treatment with disease modifying therapies (DMTs) is most effective in preventing progression of multiple sclerosis, according to a large-scale Danish study.

early treatmentThe study “Early versus Later Treatment Start in Multiple Sclerosis – A Register Based Cohort Study” is to be presented at the 2018 Annual Meeting of the American Academy of Neurology (AAN). This is to be held in Los Angeles from this Saturday, April 21, until Friday April 27.

Effects: Early treatment versus later start

The study’s research team compared long-term effects of early treatment with DMTs, against a later treatment start, in a real-world setting.

How the study was conducted is explained here.  

Data shows:

  • Patients who began treatment later had a 28% increased probability of faster disease progression. They took less time to reach EDSS 6 than those who started treatment early. This was found more pronounced in women treated later. They had a 39% increased probability of reaching EDSS 6, while men were only 9%.
  • Treatment timing, early or later, was not found to significantly change the mortality rates in patients included in the study.

Early treatment recommended

Researchers say their results “support the scheme of early treatment.”

early treatmentOn its website, the MS Society says: “Evidence now tells us that, rather than waiting to see whether more relapses occur, disease modifying therapies should be offered as close as possible to diagnosis. 

“We now know that early treatment improves long-term health and wellbeing by slowing down the build-up of irreversible damage and reducing the number of relapses people experience. Starting treatment early is best but if you start later it can also have some benefits.”

The study was supported by Sclerose Foreningen, the Danish MS association, among others.

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Affiliate disclaimer: This affiliate disclosure details the affiliate relationships of MS, Health & Disability at 50shadesofsun.com with other companies and products. Read more.

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50shadesofsun.com is the personal website of Ian Franks, a freelance medical writer and editor for various health information sites. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.

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Note: Health-related information available on 50shadesofsun website is for your general knowledge only. It is not a substitute for medical advice or treatment for specific medical conditions. I am not a doctor and cannot and do not give you medical advice. You should seek prompt medical care for any specific health issues. Also, consult a doctor before starting a new diet or exercise programme. Any opinions expressed are purely my own unless otherwise stated.

Why are DMTs – Drugs to treat MS – Resisted by so Many?

Many people with multiple sclerosis await the launch of each new disease modifying therapy (DMT), hoping it will bring some improvement.

Meanwhile, a significant number of those in the same situation seem to ignore a new drug and carry on regardless. But why?

dmts

Different DMTs for MS can be infusions, injectables, or tablets.

Well, there are a number of reasons; let’s take a look at a few of them:

  • The newly diagnosed often delay starting treatment because they are in denial or just decide to ‘wait and see’ how the disease develops.
  • Very many of us dislike taking medications of any sort, for any ailment.
  • Others say ‘no’ after researching possible side effects before they decide that they may be riskier than the disease itself.
  • Some have a type of MS for which DMTs have little or no benefit.

Of course, there are other reasons too, such as costs, and I am not decrying those.

I fully understand the ‘wait and see’ approach, especially at diagnosis, when symptoms may not be too bad. But research tells us that it is one of the worst choices that can be made. And that is equally true of clinically isolated syndrome (CIS) that can lead to MS.

DMTs: Better to start treatments early

Healthline.com explains: “Experts recommend starting one of the DMTs approved by the Food and Drug Administration as soon as a diagnosis is made. A study published in the Journal of Neuroscience Nursing, found that patients with MS or CIS benefit from starting treatment the first time they experience an event suggestive of MS.”

It continues: “Other research has found that delays in treatment, even in those with CIS, may result in more severe disability and a poorer response to treatment with DMTs later on.”

I think most of us resist taking ‘unnecessary’ medications and there is nothing wrong with that. It’s just a case of recognising, in consultation with your doctor, which treatments are needed and which aren’t.

Now, let us turn to the vexed issue of side effects. All drugs, not just ones to treat MS, have their own list of both common and rare side effects. I recommend you discuss this with your doctor, to ensure the benefits are worth any risk. The ultimate decision, however, is yours; it is your body.

Not every type of MS responds to every DMT. Most are suitable for the relapsing form of the disease where they work to prevent relapses. Relapsing patients who go on to develop Secondary Progressive MS often continue with the same drugs. Currently, nothing exists that is more suitable without having too high a risk.

For primary progressive MS patients, there is a new DMD that is now approved as a treatment in the USA. The drug is ocrelizumab, brand name Ocrevus.

DMTs for me?

I am frequently asked what drugs I take for MS. The answer, perhaps strange but nevertheless true, is ‘none’. In fact, in the 15 years since diagnosis, I have never been offered any drug treatment. Yes, I have pills to treat various symptoms but nothing for MS itself.

To be fair, though, I do check out each new drug and its side effects and there isn’t one that I’d be happy to take. A serious side effect, death, may be rare but it is final.

Enough said!

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Affiliate disclaimer: This affiliate disclosure details the affiliate relationships of MS, Health & Disability at 50shadesofsun.com with other companies and products. Read more.

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50shadesofsun.com is the personal website of Ian Franks, who has enjoyed a successful career as a journalist, from reporter to editor, in the print media. During that career he gained a Journalist of the Year award in his native UK. Diagnosed with MS in 2002, he continued to work until mobility problems made him retire early in late 2006. He now lives in the south of Spain. Besides MS, Ian is also able to write about both epilepsy and cardiovascular matters from a patient’s perspective. Besides that, he is a keen advocate on mobility and accessibility issues.