Australian-led global study finds treatments delay progression of disability in Multiple Sclerosis over the long-term

Click the following links to view media coverage of this study, or read the press release below.

Newspaper: Herald Sun (Australia)
Online: MedPage Today
Online: Medical Xpress
Online: ScienceDaily

Wednesday 16th January, 2019

The findings of an international study led by Australian researchers will influence how doctors treat Multiple Sclerosis (MS) around the world. This study is the first to provide evidence that the currently available therapies can delay progression of disability in MS.

The conversion from the relapsing to the secondary progressive stage of MS is characterised by an ongoing accumulation of disability, which leads to worsening of physical and mental capacity and deterioration of the quality of life of the patients with MS. Therefore, the capability to delay progression of disability represents an important outcome for people living with multiple sclerosis. Currently, more than 23,000 Australians are living with MS.

Results from the study are to be published in internationally-respected medical journal, JAMA today. JAMA is the third highest ranked medical journal and this research was the only multiple sclerosis related publication featured in 2018, highlighting the significance and impact of the work that was led by the Clinical Outcomes Research unit (CORe) at the University of Melbourne and Royal Melbourne Hospital.

“People who converted from relapsing MS to secondary progressive MS experience gradual and mostly irreversible worsening of disability. Most of the therapies that we use to treat MS have no effect once people have converted to secondary progressive MS. This study shows us how important it is to treat relapsing MS early and pro-actively,” said one of the study leaders,A/Prof Tomas Kalincik, the head of the MS Service at the Royal Melbourne Hospital and CORe at the University of Melbourne.

The global study, using data from 1555 patients from 68 neurological clinics across 21 countries, compares the effectiveness of five therapies being prescribed to treat patients with relapsing-remitting MS treated for at least four years. These therapies are alemtuzumab, natalizumab, interferon beta, glatiramer acetate and fingolimod.

By using observational data, the study provides a ‘real time’ head-to-head comparison of efficacy of several therapies in a broad spectrum of patients – something which cannot be extracted from clinical trials of a drug. The findings suggest that people who were treated were less likely to advance to secondary progressive MS than those who received no therapy. Moreover, those treated with fingolimod, natalizumab or alemtuzumab have a lower risk of converting to secondary progressive MS than those receiving interferon beta or glatiramer acetate.

Importantly, the study found that this effect was more significant when these treatments were started within the first five years of disease onset.

“It is reassuring for patients with MS and their neurologists to know that the therapies that they are treated with for many years significantly improve the quality of their lives over the long-term,” said A/Prof Kalincik.

BACKGROUND:

  • This study was led by Dr William Brown from Cambridge and A/Prof Tomas Kalincik from Melbourne. It was completed by neurologists and researchers from MSBase (an international collaborative research initiative based in Melbourne), Cambridge University and collaborating centres in the UK, Germany and Ireland
  • In Australia, more than 23,000 people live with Multiple Sclerosis, and more than two million worldwide
  • More than 6000 Australian patients contribute their data to the MSBase study
  • 19 hospitals and MS Centres in Australia actively participate in MSBase, including: Royal Melbourne Hospital, The Alfred Hospital, Royal Prince Alfred Hospital, Royal Adelaide Hospital, Royal Hobart Hospital, Sir Charles Gairdner Hospital in Perth, Royal Brisbane and Women’s Hospital.
  • The study examined a cohort of 1555 patients in 21 countries between 1988 and 2017.
  • The study was funded by the National Health & Medical Research Council, Australia, and the MSBase Foundation.