Early Treatment Matters in Multiple Sclerosis

Researchers have found additional evidence that earlier treatment leads to better outcomes in patients with multiple sclerosis (MS). An article published in the journal Neurology on August 10, 2015, authored by Ludwig Kappos, MD, of Departments of Medicine, Clinical Research, Biomedicine and Biomedical Engineering at the University Hospital Basel, in Switzerland, and colleagues, assessed the outcomes of patients treated immediately or after a short delay following clinically isolated syndrome (CIS).

The researchers assessed patients who had participated in a study called BENEFIT (Betaferon/Betaseron in Newly Emerging MS for Initial Treatment) 11 years earlier. In the original study, participants “were randomly assigned to receive interferon beta-1b (early treatment) or placebo (delayed treatment)” say the authors. Once they were converted to clinically definite multiple sclerosis (CDMS) or after 2 years, the patients in the placebo group could switch to interferon beta-1b or another treatment.

Several studies have demonstrated that using disease-modifying treatment at CIS can delay MS, but the researchers say “data about the effects of starting treatment this early on the long-term disease course, including potential improvements relative to delayed treatment on measures of confirmed disability progression, participation, and quality of life, are scarce.”

In the present follow-up study, 278 participants (71.3% of the original number) were enrolled. The researchers report, “After 11 years, risk of CDMS remained lower in the early-treatment arm compared with the delayed-treatment arm with longer time to first relapse and lower overall annualized relapse rate,” adding “only 25 patients converted to secondary progressive multiple sclerosis.”

This 11 year follow-up study is longer than previous studies, and includes outcome measures such as employment status and patient-reported outcomes. The researchers conclude that the present study reinforces “the importance of starting therapy with interferon beta-1b as soon as possible after the onset of MS symptoms