We present findings from 3 recent studies concerning multiple sclerosis research and treatment.
The frequency of specific autoreactive antibodies is not higher among patients with multiple sclerosis (MS) than healthy people, suggesting that these antibodies are not associated with MS or disease progression. Long-term fingolimod therapy maintains a low rate of disease activity and sustains improved efficacy in MS patients who switched from interferon Î²-1a (IFNÎ²-1a). A younger age of onset of MS is associated with more impairment in information-processing speed in adults with pediatric-onset MS compared to those with adult-onset MS.
Influence of Autoreactive Antibodies in MS.
• Immune autoreactive B cells and their antibody response have been reported to play a key role in the development of MS.
• These researchers assessed the frequency of certain autoreactive antibodies in patients with different MS forms, and matched them up with clinical and magnetic resonance imaging (MRI) measures of MS disease progression.
• They analyzed serum samples from 654 patients and 315 healthy controls for autoantibodies against three known antigens related to MS (CSF114(Glc), KIR4.1a and KIR4.1b) and against 26 different antigens linked to other autoimmune disorders, including systemic sclerosis, lupus, rheumatoid arthritis, among others.
Autoreactive Antibodies May Not Be Diagnostic in MS.
• The frequencies of the 3 autoreactive antibodies against CSF114(Glc), KIR4.1a and KIRK4.1b were similar between healthy controls and MS patients.
• None of the autoreactive antibodies analyzed differed in terms of frequency between MS patients and healthy controls.
• The researchers conclude that CSF114 and anti-KIR 4.1a and KIR 4.1b peptide antibodies might not be diagnostic for MS.
Long-term Extension Trial of Fingolimod in MS.
• The immunomodulating drug fingolimod has shown significant 1-year benefits of over IFNÎ²-1a in patients with relapsingâremitting MS.
• These researchers present the results of a long-term extension trial of 1027 MS patients who had received fingolimod treatment for up to 4.5 years.
• Three-quarters of the patients completed the extension trial.
Continuous Fingolimod Reduces Relapse Rates.
• Annualized relapse rates in patients on continuous-fingolimod 0.5 mg were significantly lower than in the interferon-switch group.
• After switching to fingolimod, patients initially treated with interferon had a 50% reduction in relapse rate, reduced MRI activity, and a lower rate of brain volume loss.
• A post hoc analysis found the proportion of interferon-switch patients with no evidence of disease activity increased by approximately 50% in the first year after switching to fingolimod treatment.
• The researchers note an earlier start of fingolimod treatment had an overall stronger impact on the control of clinical disease activity.
Cognitive Outcomes in Pediatric-onset MS.
• Little is known about long-term cognitive and patient-reported outcomes of pediatric-onset MS.
• Cognitive and patient-reported outcomes may differ in adults with pediatric-onset MS than in those who develop the disease later in life.
• These researchers compared 51 pediatric-onset MS patients’ and 550 adult-onset MS patients’ scores on Multiple Sclerosis Quality of Life-54, Modified Fatigue Impact Scale, Center for Epidemiologic Studies Depression Scale, and Symbol Digit Modalities Test.
Information Processing Differs by Age of MS Diagnosis.
• Scores on the modalities test were significantly lower in pediatric-onset MS after adjusting for age, but not after adjusting for disease duration.
• No significant differences were observed in health-related quality-of-life, fatigue, depression or social support between the two groups.
• The 2 groups were similar in terms of patient-reported outcomes, suggesting similar qualitative experiences of MS.
• The frequency of autoantibodies in MS patients is similar to that of healthy controls, and the presence of autoreactive antibodies is not associated with clinical and MRI measures of MS disease progression.
• A long-term extension trial shows sustained benefits of fingolimod on relapses and MRI inflammatory activity in continuously treated and interferon-switch MS patients.
• A younger age at diagnosis of pediatric-onset MS is associated with a greater impairment in information processing speeds in adulthood, compared with those with adult onset MS.