A currently available drug may help delay symptoms

Multiple sclerosis is a disease that affects the brain and spinal cord. In MS, the immune system attacks the protective coating that covers nerve fibers, called myelin. This disrupts communication between the brain and the rest of the body, eventually leading to permanent damage or deterioration of nerve fibers.

Symptoms MS vary, but may include the following:

• Numbness or weakness in one or more limbs
• Tingling
• Electric shock sensations that occur with certain neck movements
• Lack of coordination
• Difficulty walking
• Vision problems, including double vision, partial vision loss or blurring in one eye
• vertigo
• Problems with bladder function
• Fatigue
• Cognitive problems

The preliminary study, which will be presented at the 75th annual meeting of the American Academy of Neurology, involved 89 people with the radiologically isolated syndrome. Half of the people received teriflunomide daily and the other half received a placebo. Both groups were followed for up to two years.

The results revealed that eight people who took teriflunomide developed symptoms of MS, compared to 20 who took the placebo and developed symptoms of MS. This shows that the drug reduced the risk of experiencing the first symptoms by 72%.

“The results make a lot of sense,” Smith added. “If we have someone who is presymptomatic, meaning they look like they have MS from an MRI, and we give them a drug that prevents them from developing new symptoms, that has sense. The goal is to diagnose MS earlier and earlier. It’s not a new drug, it was just given earlier than we normally would.

” I do not think so [this study] is everything new,” said Dr. Asaph Harel, director of the Multiple Sclerosis Center at Lenox Hill Hospital. “We know that our treatments are likely to work even in very early MS cases, and even in MS cases that haven’t yet caused symptoms.”

Teriflunomide is a drug that doctors have used for many years to treat MS. It acts to inhibit the function of immune cells that have been affected by MS. It helps prevent further damage to the brain and spinal cord, which can delay the onset of symptoms.

The difference is that this study gave the drug to patients before they were diagnosed with MS. Instead, what they were diagnosed with was radiologically isolated syndrome (RIS). RIS looks like MS in an MRI, but they are asymptomatic. Therefore, if a person’s MRI shows these lesions, it could potentially lead to a misdiagnosis of MS, when in fact a person has RIS.

“The barrier [to this study] is to make sure we don’t diagnose anyone early. Making that diagnosis can sometimes be difficult and someone may be prescribed this drug for 30 years, but it’s not necessarily a drug they need,” Smith said.

The problem, however, is that if the lesions predate MS, it’s best to catch it early because once MS symptoms start, you can’t go back and correct them.

“I think the question is always who needs this treatment and who doesn’t,” Harel added. “We don’t have an effective way of predicting, on an individual level, who will develop symptoms. Therefore, even if it is effective at the group level, it is still unclear whether it is worth using it, as some people with IRS do not eventually develop MS symptoms. »

“Otherwise, however, preventing damage before it happens is a good thing. The earlier one diagnoses, the better. It’s just trying to find the balance between misdiagnosis and early, accurate diagnosis,” Smith said.