Wednesday, January 31, 2007

extension trials in MS-- Noseworthy

Extension trials-- limited benefit Noseworthy JH How much can we learn from long-term extension trials in multiple sclerosis? Neurology 2006; 67: 930-931 editorialcomments on Kappos et al. Long term interferon beta 1a therapy in patients with relapsing MSNeurology 67: 944-953 200632 % patients randomized in PRISMS did not participate in the extension. Blinding was eliminated. Visits were in some cases conducted every two years or retrospecive evaluations were substituted. About 25 % patients entering extension did not remain on treatment. Brain atrophy was not reduced. The NTT (number to treat) early v 24 months later to prevent one point progression on EDSS was 27. Conclusion of safety is warranted, not that of efficacy.Kappos et al-- 382 patients followed 8 years. 19 % progressed to spms. NABS generally disappeared with treatment. The authors claim 44 dose worked better than 22. 396/560 patients had EDSS < 3 at baseline; of those, 27 % went to EDSS of 4, 20 % went to an EDSS of six, 12 % to 6.5, and 6 % to edss of 7. Relapse rate was about .61 per patient per year in treated patients.

Monday, January 29, 2007

Antimeylin Antibodies and progression to MS

462 patients with CIS and at least 2 clinically silent lesions had anti MOG and anti MBP IgG and IgM antibodies measured with Western blot, and were followed for 24 months. There was no association found between the antibodies being present and the development of CDMS