MS research update - 11 September 2009
- People with MS more likely to suffer headaches
- MS does not alter cancer risk
- Early treatment reduces conversion to definite MS but does not reduce progression of disability in the long term.
People with MS more likely to suffer headaches
Headache is not a symptom that is typically associated with MS, yet several studies have shown that people with MS suffer headaches as much as 50% more frequently than the general healthy population. These studies also suggest that headaches can be experienced at onset of the condition and during the course of it. This study reviews the current evidence of increased prevalence of headache in the MS population and seeks to draw associations between the occurrence of headache, the specific clinical characteristics of MS, and MS drug therapies. The prevalence of headache in general was not related to types of MS, length of time an individual had MS, or the extent of their disability. Headache features did not appear to be MS specific though tension-type headache and migraine without aura are the most commonly reported types of primary headache. The authors also point to the disease modifying drug therapies such as the beta interferons and note that these drugs may cause or worsen headaches.
La Mantia L.
Headache and multiple sclerosis: clinical and therapeutic correlations.
Neurological Sciences 2009; 30 Suppl 1:S23-6.
Medline abstract
MS does not alter cancer risk
Many previous research studies have sought to determine whether MS alters an individual's risk of developing other disorders or conditions. The present study sought to determine whether people with motor neurone disease, MS, or Parkinson's disease were at any greater or lesser risk for developing cancer before and after diagnosis of their condition. The study based its conclusions on the analysis of hospital-collated statistics for a specific region of South England. Based on these statistics, only people with Parkinson's Disease showed a significant difference in the overall incidence of cancer compared the general population. People with motor neurone disease or MS do not have an altered risk of cancer overall.
Fois AF, Wooton CJ, Yeates D, et al.
Cancer in patients with motor neuron disease, multiple sclerosis, and Parkinson's disease: record-linkage studies.
Journal of Neurology Neurosurgery and Psychiatry 2009 [Epub ahead of print].
Medline abstract
Early treatment reduces conversion to definite MS but does not reduce progression of disability in the long term.
The original 2-year BENEFIT (Betaferon in newly emerging multiple sclerosis for initial treatment) trial, investigated the effect of starting interferon beta 1b after a clinically isolated syndrome (clinically isolated syndrome or CIS is an individual's first neurologic episode lasting at least 24 hours). Study participants received either interferon beta 1b or placebo every other day for two years. At the end of the two years all study participants were eligible to enter the follow-up phase and receive interferon beta 1b treatment for a further three years. The comparison made at the end of five years was made between the group of people who presented with a CIS five years earlier and started treatment with interferon beta 1bstraight away, and the group of people who presented with CIS five years earlier but had been receiving placebo for the first two years. The study thus sought to determine the effect of delaying treatment with interferon beta 1b after CIS by two years. At the end of five years, the study findings indicate that earlier treatment with interferon beta 1b reduced the risk of conversion from CIS to clinically definite MS by 37%. However, at the end of the five years there was no significant difference between the two groups in terms of the level of disability progression as assessed by EDSS (a clinical scale that is used to rank levels of disability). Thus, the study authors conclude that delaying treatment by two years had no significant effect. This study throws open the debate about the benefits of starting disease modifying drug treatment after a clinically isolated syndrome.
Kappos L, Freedman MS, Polman CH, et al.
Long-term effect of early treatment with interferon beta-1b after a first clinical event suggestive of MS: 5-year active treatment extension of the phase 3 BENEFIT trial.
Lancet Neurol 2009; [Epub ahead of print]
Medline abstract