Tremor Under-Treated in MS

Fewer than half the participants in a recent study benefited from medications to treat tremor in multiple sclerosis (MS), demonstrating that tremor remains poorly treated in MS patients. The study, conducted by William Meador, MD, with the Department of Neurology at the University of Alabama, and colleagues, was published in the International Journal of MS Care.

The researchers conducted a survey using the North American Research Committee on Multiple Sclerosis (NARCOMS), which is a multiple sclerosis patient registry with more than 37,000 people with MS listed. They said they “expected to find that symptomatic medications offered modest reported benefit and that patients with more severe tremor would be more likely to report symptomatic medication use and benefit.”

A total of 508 responses were included in the analysis. They were divided into groups based on whether or not they reported taking any of a specific list of medications for tremor. About half (46.9%) did take a medication to treat tremor, 12 had undergone surgery to lessen the severity of tremor, and 20 reported having stopped a medication due to worsening tremor.

Upon examining differences between those who took medication to treat tremor and those who didn’t, the researchers said they found two important differences: “first, the higher rates of disability and unemployment in users of symptomatic therapy and, second, the consistency of a trend toward greater MS and tremor severity in medication users.”

The results led the researchers to note, “We must acknowledge that these results reinforce the widespread impression that medical treatments for MS tremor are neither widely used nor perceived as especially beneficial.” They go on to say that only half of patients with moderate or severe tremor report any benefit from taking medication to suppress tremor, and that the results imply “a large, unmet need for symptomatic treatments.”

Although there are limitations inherent in a retrospective study based on patient answers to a questionnaire, the results “clearly support the notion that tremor results in significant functional impairment in MS, that symptomatic medications for tremor are infrequently used and often inadequate, and that better treatment options for patients with MS constitutes an unmet need,” the researchers conclude.