As with other neurodegenerative diseases, multiple sclerosis (MS) begins to cause damage to the body before it is diagnosed. A clinical trial has shown that detecting the disease in its early stages and administering treatment as soon as possible can slow its progression. Specifically, it has shown that the drug teriflunomide can delay the first symptoms of multiple sclerosis in people in whom magnetic resonance imaging (MRI) has revealed signs of the disease, although they have not yet experienced its symptoms, which is known as radiologically isolated syndrome.
The preliminary study has not yet been published in a scientific journal and will be presented at the 75th Annual Meeting of the American Academy of Neurology in Boston April 22-27. Radiologically isolated syndrome is diagnosed in people who do not have symptoms of MS, but have lesions in the brain or spinal cord that precede the MS.
Multiple sclerosis occurs because the patient’s own immune system attacks myelin, the white fatty substance that is responsible for insulating and protecting the nerves and its symptoms include motor problems such as heavy legs or difficulties walking, the sensation of tingling or numbness, fatigue or depression.
“Early intervention with teriflunomide may be beneficial for people diagnosed with radiologically isolated syndrome, the presymptomatic phase of multiple sclerosis”
“With more and more people undergoing brain scans for various reasons, such as headaches or head trauma, more of these cases are being discovered, and many of these people develop MS,” said study author Dr. Christine Lebrun Frenay of the University Hospital of Nice (France) and member of the American Academy of Neurology. “The sooner a person can be treated for MS, the better the chances of delaying damage to myelin, which decreases the risk of permanent neurological impairment and debilitating symptoms.”
Reduce the damage caused by multiple sclerosis
The study involved 89 people with radiologically isolated syndrome, half of whom received 14 milligrams (mg) of teriflunomide daily, while the other half received a placebo. Follow-up lasted up to two years, and during this time only eight people taking the drug developed multiple sclerosis symptoms, compared with 20 taking the placebo.
The researchers adjusted for other factors that could influence the chances of developing symptoms and found that individuals taking teriflunomide had a 72% lower risk of experiencing first symptoms than those taking placebo.
“Our findings suggest that early intervention with teriflunomide may be beneficial for people diagnosed with radiologically isolated syndrome, the presymptomatic phase of MS,” said Lebrun Frenay. “However, more research in larger groups of people is needed to confirm our findings. Furthermore, it is important that medical professionals exercise caution when using MRI expertise to diagnose this condition, selecting only patients at risk of developing MS and not increasing MRI misdiagnosis.” The study has been supported by Sanofi, the company that makes teriflunomide.
Speaking to SMC Spain, Luis Querol, a neurologist specializing in autoimmune and neuromuscular neurological diseases at the Sant Pau Hospital in Barcelona, specifies that the results of the study are “relatively logical”, and explains that currently “multiple sclerosis has been considered a continuum since the first lesions appear –even if they do not give symptoms– until you really have symptoms and make the first outbreaks. Teriflunomide is an effective drug that has already been shown to work in clinical trials with patients with conventional multiple sclerosis. The logical thing is that it worked [en pacientes todavía sin síntomas] and so it has been.”
But he adds that “it is good that the evidence is formalized to be able to use the treatments as soon as possible without having to wait for the patients to develop symptoms”, in which “The results are even better, and there is plenty of evidence in this regard: how much The sooner you start a therapy, the better results you have”. “It is not a revolutionary study because it is something that we all expected, but at the same time it provides us with very useful information and, above all from a practical point of view, it gives us the opportunity to use these drugs that until now have been restricted to those patients who already meet all the criteria for multiple sclerosis.
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