URL of this page: http://www.nlm.nih.gov/medlineplus/podcast/transcript091712.html
NLM Director’s Comments Transcript
MS Drug Treatment Challenges: 09/17/2012
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what's new this week in MedlinePlus.
A widely prescribed drug to treat multiple sclerosis (MS) thwarts some symptoms but in a surprising finding -- may not slow the onset of disability, suggest a study and accompanying editorial recently published in the Journal of the American Medical Association.
In a comparison of 868 MS patients who received one of four preparations of interferon beta with 1,788 patients who did not receive the medication, there was no difference in the rate of progression (or onset of long-term disability) between the three study groups. Of the two study groups that did not receive interferon, one group did not take the medication because it was unavailable when their MS initially was diagnosed. The other group did not take interferon after it became clinically available. All three groups were followed from five to almost 11 years within a study period from 1985-2008.
The research suggests the interferon recipients in the Canadian-based study developed significantly fewer brain lesions and less frequent MS relapses compared to patients who did not take this medication.
However, the findings were equivocal about a larger question — if interferon effectively prevents the onset of an irreversible disability that is frequently associated with MS among adult patients? In contrast with previous research, the study suggests there is no statistical association between interferon and the onset of disability regardless of: gender, MS duration, relapse rate, and other factors.
The study’s lead author told the New York Times the findings also suggest relapses and brain lesions may be unrelated to the initiation of disability for MS patients. The editorial accompanying the study in JAMA notes these findings counter previous research as well as clinical wisdom about optimal MS treatment approaches.
The study’s 10 researchers explained the contrasts between the current and previous study’s findings reflect some improved methodological approaches.
While the editorial accompanying the current study describes the research as (and we quote) ‘rigorously conducted’ (end of quote), the editorial notes the study adds more uncertainty about the link between interferon and the onset of disability than demonstrating the medication’s preventive incapacity.
The editorial’s authors write (and we quote) ‘lacking evidence of treatment effect is not proof of lacking effect’ (end of quote).
The editorial emphasizes the study’s findings (and we quote) ‘reinforce the conclusion that the associations between use of interferons and long-term disability, although plausible, remain unproven’ (end of quote).
To enhance MS patient care in the future, the study’s authors conclude new, effective treatment options are needed as well as more rigorous criteria to better match patients with optimal treatments.
MedlinePlus.gov reports different preparations of interferon are a widely used medication to treat the most common form of MS. MedlinePlus.gov’s multiple sclerosis health topic page explains MS is a disease of the immune system (or an autoimmune disease) where the myelin sheath that surrounds nerve cells are damaged. While MS’ course varies significantly among patients, some known symptoms include: muscle spams, difficulty walking, bladder and bowel problems, vision and hearing impairments, as well as challenges in reasoning and attention span.
The editorial that accompanies the study notes MS affects from 2 to 2.5 million men and women worldwide. The editorial’s authors write (and we quote): ‘The majority of – but not all– patients with MS develop severe disability 10 to 20 years after diagnosis’ (end of quote).
MedlinePlus.gov contains helpful information about the preparations of interferon used in MS treatment within the drugs/supplements section on MedlinePlus.gov’s home page. Interferon beta 1a is an intramuscular injection while another preparation (interferon beta 1a) is a subcutaneous (under-the-skin) injection. A third type of interferon (beta 1b) also is subcutaneous. Some of the issues discussed within the interferon beta pages include: when the medicine should be used, why is it prescribed, and a list of side effects.
An overview of approved MS medications (provided by the National Multiple Sclerosis Society) is available in the ‘treatment’ section of MedlinePlus.gov’s multiple sclerosis health topic page. Additional information intended to help MS patients stay well (also from the National Multiple Sclerosis Society) is available in the ‘disease management’ section of MedlinePlus.gov’s multiple sclerosis health topic page.
A recommended website from Harvard Medical School (available in the ‘diagnosis/symptoms’ section of MedlinePlus.gov’s multiple sclerosis health topic page) provides questions for MS patients to ask their doctor, which covers MS’ diagnosis, treatment, and disease management.
MedlinePlus.gov’s multiple sclerosis health topic page additionally contains links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to related clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. From the multiple sclerosis health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.
To find MedlinePlus.gov’s multiple sclerosis health topic page, type ‘MS’ in the search box on MedlinePlus.gov’s home page, then, click on ‘multiple sclerosis (National Library of Medicine).’
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A disclaimer – the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider. I want to take the opportunity to wish you a very happy holiday season and a healthy New Year. The National Library of Medicine and the 'Director's Comments' podcast staff, including Dr. Lindberg, appreciate your interest and company – and we hope to find new ways to serve you in 2012.
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