Mark Henderson, Science Editor
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A step change in the treatment of multiple sclerosis is heralded today by the first study to suggest that a drug can stop the disease in its tracks and even reverse its progress.
A trial of the medicine, known as alemtuzumab, has found that it offers benefits that are “better by a country mile” than other treatments for MS, and that it is effective for a much wider cross-section of patients.
The results offer hope that thousands of people who suffer from MS will eventually be able to control the condition, which causes nerve damage, loss of mobility, blindness and cognitive decline.
Scientists cautioned, however, that alemtuzumab will not be available outside clinical trials for about five years, and that it is suitable only for patients with early-phase MS. Those in whom the disease has already been diagnosed are unlikely to benefit.
When people with early-stage MS were treated with alemtuzumab, their condition improved significantly more than those on beta interferon, the best treatment available now, across three standard clinical indicators.
The drug reduced the number of MS attacks by 74 per cent, and the progression of disability by 71 per cent, when compared with beta interferon. Patients on alemtuzumab also showed recovery of brain function, so that they were less disabled at the end of the three-year study than at the beginning, while those on beta interferon continued to decline.
Almost every patient taking alemtuzumab improved, whereas about half of MS patients show no response to beta interferon.
Scientists behind the research said that if the findings were repeated in a larger sample it would promise a revolution in MS care within five years, though only for patients who had yet to develop much nerve damage.
“It is a landmark, a step change,” said Alistair Compston, Professor of Neurology at the University of Cambridge, who led the study. “It is more effective than beta interferon by a country mile, and the efficacy is so high that we hope it will represent the definitive treatment if used in the right people.”
Alasdair Coles, another member of the team, said: “It is our view that alemtuzumab offers the most effective treatment for relapsing-remitting multiple sclerosis described to date. The ability of an MS drug to promote brain repair is unprecedented. We are witnessing a drug which, if given early enough, might effectively stop the advancement of the disease and also restore lost function by promoting repair of damaged brain tissue.”
The study, which is published in The New England Journal of Medicine, was a phase 2 trial, conducted on 334 patients as the first test of the drug's efficacy. Two phase 3 trials, of 600 and 1,200 patients, are now under way and positive reports will be needed from these before it can be licensed. Alemtuzumab was also shown to have some potentially serious side-effects, which means that patients who take it will have to be monitored by their doctors. One patient taking the drug died of a brain haemorrhage after developing an autoimmune condition that destroys a clotting agent in the blood, and two others were successfully treated for the same disorder.
Lee Dunster, head of research at the MS Society, said that the charity was delighted at the results. “This news will rightly bring hope to people living with the condition day in, day out.”
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