Summary: According to researchers, a drug used to treat multiple sclerosis could help to reverse some of the physical disabilities associated with the disease.
A drug used to treat multiple sclerosis (MS), alemtuzumab, was found to reverse some of the physical disability caused by the disease, according to new research published in the October 12, 2016, online issue of Neurology. Because it can cause serious side effects, alemtuzumab is generally used in people who have not responded well to other MS drugs; however, in this study it was used relatively early in the course of MS.
The drug is used in relapsing-remitting MS, the most common form of the disease, in which symptoms alternate between sudden worsening and remission.
“While many MS drugs slow the progress of disability, there have been little data about the ability of current treatments to help restore function previously lost to MS,” said study author Gavin Giovannoni, MD, PhD, of Queen Mary University of London, United Kingdom.
For the study, people with relapsing-remitting MS who did not respond well to at least one other MS drug were treated either with alemtuzumab (426 people) or the drug interferon beta-1a (202 people).
Researchers assessed the participants’ level of disability at the beginning of the study and again every three months for two years. By the end of the study, nearly 28 percent of those receiving alemtuzumab had improved by at least one point on a disability test, with scores ranging from zero to 10, compared to 15 percent of those receiving interferon. People receiving alemtuzumab were 2.5 times more likely to improve on the assessment of thinking skills than those receiving interferon, and were more than twice as likely to improve on the ability to move without tremor or clumsy movements known as ataxia. The researchers adjusted the results to make sure the improvements were not driven by people recovering from recent relapses.
Giovannoni noted that the benefits of alemtuzumab, if confirmed, need to be considered along with its risks, which include the risk of serious and rarely fatal autoimmune problems as well as infusion reactions.
“These results are encouraging, but exactly how alemtuzumab may reverse damage, whether it’s through repairing myelin, creating new nerve synapses, greatly reducing inflammation or some other mechanism, is yet to be investigated,” said Bibiana Bielekova, MD, of the National Institute of Neurological Disorders and Stroke in Bethesda, Md., and Fellow of the American Academy of Neurology, who wrote a corresponding editorial. “Longer studies are also needed to see how many people experience, or do not experience, improvement in disability over longer periods of time.”
About this neurology research article
Funding: The study was supported by Sanofi Genzyme and Bayer HealthCare Pharmaceuticals.
Source: Renee Tessman – AAN Image Source: NeuroscienceNews.com image is in the public domain. Original Research:Abstract for “Alemtuzumab improves preexisting disability in active relapsing-remitting MS patients” by Gavin Giovannoni, Jeffrey A. Cohen, Alasdair J. Coles, Hans-Peter Hartung, Eva Havrdova, Krzysztof W. Selmaj, David H. Margolin, Stephen L. Lake, Susan M. Kaup, Michael A. Panzara, and D. Alastair S. Compston, On behalf of the CARE-MS II Investigators in Neurology. Published online October 12 2016 doi:10.1212/WNL.0000000000003319
Cite This NeuroscienceNews.com Article
[cbtabs][cbtab title=”MLA”]AAN “Multiple Sclerosis Drug May Reverse Some Physical Disability.” NeuroscienceNews. NeuroscienceNews, 13 October 2016. <https://neurosciencenews.com/ms-pharmacology-disability-reversal-5290/>.[/cbtab][cbtab title=”APA”]AAN (2016, October 13). Multiple Sclerosis Drug May Reverse Some Physical Disability. NeuroscienceNew. Retrieved October 13, 2016 from https://neurosciencenews.com/ms-pharmacology-disability-reversal-5290/[/cbtab][cbtab title=”Chicago”]AAN “Multiple Sclerosis Drug May Reverse Some Physical Disability.” https://neurosciencenews.com/ms-pharmacology-disability-reversal-5290/ (accessed October 13, 2016).[/cbtab][/cbtabs]
Alemtuzumab improves preexisting disability in active relapsing-remitting MS patients
Objective: To characterize effects of alemtuzumab treatment on measures of disability improvement in patients with relapsing-remitting multiple sclerosis (RRMS) with inadequate response (≥1 relapse) to prior therapy.
Methods: Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis (CARE-MS) II, a 2-year randomized, rater-blinded, active-controlled, head-to-head, phase 3 trial, compared efficacy and safety of alemtuzumab 12 mg with subcutaneous interferon-β-1a (SC IFN-β-1a) 44 μg in patients with RRMS. Prespecified and post hoc disability outcomes based on Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC), and Sloan low-contrast letter acuity (SLCLA) are reported, focusing on improvement of preexisting disability in addition to slowing of disability accumulation.
Results: Alemtuzumab-treated patients were more likely than SC IFN-β-1a–treated patients to show improvement in EDSS scores (p < 0.0001) on all 7 functional systems. Significantly more alemtuzumab patients demonstrated 6-month confirmed disability improvement. The likelihood of improved vs stable/worsening MSFC scores was greater with alemtuzumab than SC IFN-β-1a (p = 0.0300); improvement in MSFC scores with alemtuzumab was primarily driven by the upper limb coordination and dexterity domain. Alemtuzumab-treated patients had more favorable changes from baseline in SLCLA (2.5% contrast) scores (p = 0.0014) and MSFC + SLCLA composite scores (p = 0.0097) than SC IFN-β-1a–treated patients.
Conclusions: In patients with RRMS and inadequate response to prior disease-modifying therapies, alemtuzumab provides greater benefits than SC IFN-β-1a across several disability outcomes, reflecting improvement of preexisting disabilities.
Classification of evidence: This study provides Class I evidence (based on rater blinding and a balance in baseline characteristics between arms) that alemtuzumab modifies disability measures favorably compared with SC IFN-β-1a.
“Alemtuzumab improves preexisting disability in active relapsing-remitting MS patients” by Gavin Giovannoni, Jeffrey A. Cohen, Alasdair J. Coles, Hans-Peter Hartung, Eva Havrdova, Krzysztof W. Selmaj, David H. Margolin, Stephen L. Lake, Susan M. Kaup, Michael A. Panzara, and D. Alastair S. Compston, On behalf of the CARE-MS II Investigators in Neurology. Published online October 12 2016 doi:10.1212/WNL.0000000000003319