Early Treatment of Demyelination Events Cuts Long-Term Disability in MS

Reduced risk for reaching EDSS 3.0, secondary progressive MS, sustained disease progression seen with very early treatment

By Elana Gotkine HealthDay Reporter

THURSDAY, July 20, 2023 (HealthDay News) — For multiple sclerosis patients with a first demyelinating event, earlier treatment initiation is associated with a reduction in the risk for long-term disability, according to a study published online July 19 in Neurology.

Alvaro Cobo-Calvo, M.D., Ph.D., from Hospital Universitari Vall d’Hebron in Barcelona, Spain, and colleagues examined the association between receiving very early treatment and the risk for long-term disability, including a five-point magnetic resonance score (MRS), in patients with a first demyelinating event. Data were included for 580 patients who received at least one disease-modifying drug (DMD). Participants were classified into tertiles according to the time from first demyelinating event to first DMD: first tertile (six months; 194 patients); second tertile (6.1 to 16 months; 192 patients); and third tertile (16.1 months onward; 194 patients).

The researchers found that compared with patients in the third tertile, very early treatment reduced the risk for reaching Expanded Disability Status Scale 3.0, secondary progressive multiple sclerosis, and sustained disease progression at 12 months after treatment initiation (hazard ratios, 0.55, 0.40, and 0.50, respectively). Compared with patients in the third tertile, those in the first tertile had a lower disability progression rate (β estimate, −0.009) and a lower severe disability measured by the Patient Determined Disease Steps (β estimate, −0.52). A 62.4 percent reduction was seen in the median time between the first demyelinating event and the first-ever treatment initiation from patients displaying a raw MRS1 to patients with a raw MRS5.

“Altogether, our results support the robustness and effectiveness of very early treatment to halt long-term disability progression, and stress that earlier detection and treatment is encouraged,” Cobo-Calvo said in a statement.

Several authors disclosed ties to the pharmaceutical industry.

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