Drug may reverse MS brain damage

<http://news.bbc.co.uk/2/hi/health/7680641.stm>http://news.bbc.co.uk/2/hi/health/7680641.stm
 

By Richard Warry
BBC News website health editor
[]

MS X-rays

MS causes damage to the nerves

A drug developed to treat leukaemia may be a powerful new weapon 
against multiple sclerosis, researchers say.

Alemtuzumab appears to stop progression of the disease in patients 
with early stage active relapsing-remitting MS - the most common form 
of the condition.

The University of Cambridge study, published in the New England 
Journal of Medicine, also suggests the drug may enable repair of 
previous damage.

However, it can produce potentially serious side-effects, they warn.

[]

[]
  The ability of an MS drug to promote brain repair is unprecedented
[]

Dr Alasdair Coles
University of Cambridge
[]

'Drug saved my golf career'

And the researchers stress their work is still at an early stage.

Alemtuzumab - a type of drug known as a monoclonal antibody - was 
created at Cambridge in the late 1970s, and has long been used to 
treat leukaemia by killing off the cancerous white cells of the immune system.

The latest three-year study, of 334 patients with relapsing-remitting 
MS which had yet to be treated, found that the drug cut the number of 
attacks of disease by 74% more than the reduction achieved by 
conventional interferon-beta therapy.

Alemtuzumab also reduced the risk of sustained accumulation of 
disability by 71% compared to beta-tinterferon.

People on the trial who received the drug also recovered some 
function that had been thought to be permanently lost, and as a 
result were less disabled after three years than at the beginning of 
the study.

In contrast, people given interferon-beta showed signs of 
progressively worsening disability.

This was confirmed by brain scans in which alemtuzumab patients 
showed signs that their brains had actually increased in size, while 
the beta-interferon patients' brains shrank over time.

The researchers said the findings suggested that alemtuzumab may 
allow damaged brain tissue to repair itself.

However, they stress that more work is needed to confirm the effects, 
before the drug can be considered for widespread NHS use.

Lead researcher Professor Alastair Compston said: "Alemtuzumab is the 
most promising experimental drug for the treatment of multiple 
sclerosis, and we are hopeful that the phase three trials will 
confirm that it can both stabilise and allow some recovery of what 
had previously been assumed to be irreversible disabilities."

Auto-immune disease

MS is caused by a fault in the body's immune system which leads it to 
attack nerve fibres and their protective insulation, the myelin sheath.

[]

[]
  This news will rightly bring hope to people living with the 
condition day in, day out
[]

Lee Dunster
MS Society

This damage prevents the nerves from 'firing' properly, and then 
leads to their destruction, resulting in physical and intellectual 
disabilities.

Alemtuzumab works by destroying a type of white blood cell called a 
lymphocyte, which, in MS, plays a key role in causing the damage 
associated with the disease.

Effectively, this shuts down the immune system, allowing it to 
re-boot without the original fault.

Dr Alasdair Coles, who also worked on the study, said: "The ability 
of an MS drug to promote brain repair is unprecedented.

"We are witnessing a drug which, if given early enough, might 
effectively stop the advancement of the disease and also restore lost 
function by promoting repair of the damaged brain tissue."

During the trial, 20% of patients treated with alemtuzumab developed 
either an under-active or over-active thyroid gland.

A small number developed a low platelet count, rendering them 
vulnerable to bleeding, and in one case this led to a fatality. 
However, the researchers stress this complication can be easily 
treated if recognised early.

Lee Dunster, head of research at the MS Society, said: "This is the 
first drug that has shown the potential to halt and even reverse the 
debilitating effects of MS and this news will rightly bring hope to 
people living with the condition day in, day out.

"More work is needed to prove the drug's long-term effectiveness and 
we are very much looking forward to the results of the next stage of 
this important research."

Professor Paul Matthews, of Imperial College, London, described the 
trial as "compelling".

However, he said: "Alemtuzumab was associated with severe adverse 
events in a small proportion of the patients, suggesting that it 
would be unsuitable for any patient except those with very aggressive 
forms of the disease."

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