Double-drug therapy may benefit some multiple sclerosis patients

May 10, 2001

WINST0N-SALEM, N.C. - People with the most common types of multiple sclerosis who don't respond to traditional therapy may benefit from a combination drug therapy, a Wake Forest University Baptist Medical Center (WFUBMC) researcher reported today at the annual meeting of the American Academy of Neurology in Philadelphia, Penn.

In a pilot study, patients with aggressive relapsing-remitting or secondary progressive multiple sclerosis (MS) whose disease wasn't controlled with interferon beta-1B, a commonly used treatment, showed a reduction in disease progression when mitoxantrone was added.

"Our study, which was the first to test the safety and effectiveness of this combination of drugs, showed that it may be an effective therapy for a significant number of patients," said Douglas Jeffery, M.D., assistant professor of neurology at WFUBMC and the study's principal investigator.

Jeffery said that 35 percent to 50 percent of MS patients don't have an optimal response when taking interferon beta-1B and might benefit from the combination therapy.

The study enrolled 10 patients who continued to have attacks, or relapses, during at least six months of treatment with interferon beta-1b (sold under the brand name Betaseron). In addition, magnetic resonance imaging (MRI) showed that these patients, while on monotherapy, continued to develop brain plaques or scarring from MS. These lesions are from damage to myelin, the sheath that protects nerve fibers. The patients developed a mean of three new lesions a month.

Mitoxantrone (sold under the brand name Novantrone) was then added to the patients' therapy for six months. This medication, originally used to treat cancer, was approved for MS treatment last fall. During this treatment period, relapses and new lesions were reduced by 50 percent.

"This is significant because patients in the study had aggressive MS that wasn't responsive to standard treatment," said Jeffery. "The combination therapy shows excellent promise for patients who aren't successfully controlled on monotherapy. It was safe and showed no toxicity."

MS is a disease of the central nervous system that affects the brain and spinal cord. It strikes an estimated 250,000 people in the United States and is the major acquired neurologic disease in young adults. Common signs and symptoms of MS include fatigue, psychological and cognitive changes, weakness or paralysis of limbs, numbness, vision problems, speech difficulties, problems with walking or motor skills, bladder problems, and sexual dysfunction.

Relapsing-remitting MS, the most common form of the disease, is characterized by attacks interspersed with stable periods. About 75 percent of people are originally diagnosed with this form of the disease. Secondary progressive MS is the second stage of MS for nearly half the patients initially diagnosed as relapsing-remitting. In this stage, there are periods of intermittent attacks and remissions before the disease begins a course of steady progression.

Other less common forms include primary-progressive MS, in which the symptoms generally do not remit, and progressive-relapsing MS, which is characterized by obvious acute attacks.
WFUBMC cares for more than 2,000 patients with MS. It operates a multi-disciplinary clinic that enables patients to see an array of MS specialists during each visit. The treatment team includes specialists in neurology; nursing; clinical nutrition; physical, occupational, speech, recreational and respiratory therapies; social work; clinical psychology; assistive technology and pastoral care.

Wake Forest Baptist Medical Center

Related Multiple Sclerosis Articles from Brightsurf:

New therapy improves treatment for multiple sclerosis
A new therapy that binds a cytokine to a blood protein shows potential in treating multiple sclerosis, and may even prevent it.

'Reelin' in a new treatment for multiple sclerosis
In an animal model of multiple sclerosis (MS), decreasing the amount of a protein made in the liver significantly protected against development of the disease's characteristic symptoms and promoted recovery in symptomatic animals, UTSW scientists report.

Not all multiple sclerosis-like diseases are alike
Scientists say some myelin-damaging disorders have a distinctive pathology that groups them into a unique disease entity.

New therapeutic options for multiple sclerosis in sight
Strategies for treating multiple sclerosis have so far focused primarily on T and B cells.

Diet has an impact on the multiple sclerosis disease course
The short-chain fatty acid propionic acid influences the intestine-mediated immune regulation in people with multiple sclerosis (MS).

The gut may be involved in the development of multiple sclerosis
It is incompletely understood which factors in patients with multiple sclerosis act as a trigger for the immune system to attack the brain and spinal cord.

Slowing the progression of multiple sclerosis
Over 77,000 Canadians are living with multiple sclerosis, a disease whose causes still remain unknown.

7T MRI offers new insights into multiple sclerosis
Investigators from Brigham and Women's Hospital have completed a new study using 7 Tesla (7T) MRI -- a far more powerful imaging technology -- to further examine LME in MS patients

How to improve multiple sclerosis therapy
Medications currently used to treat multiple sclerosis (MS) can merely reduce relapses during the initial relapsing-remitting phase.

Vaccinations not a risk factor for multiple sclerosis
Data from over 12,000 multiple sclerosis (MS) patients formed the basis of a study by the Technical University of Munich (TUM) which investigated the population's vaccination behavior in relation to MS.

Read More: Multiple Sclerosis News and Multiple Sclerosis Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to