The importance of early treatment

When should you begin treatment with a multiple sclerosis disease–modifying therapy?

Guidelines from the National MS Society recommend that “treatment should be considered as soon as possible following a definite diagnosis of MS with active disease (ie, recent relapses and/or new lesions on MRI).”1

Furthermore, due to the positive results of recent clinical trials on treating early MS, the National MS Society also recommends that treatment “may also be considered for some patients with a first attack who are at high risk of developing MS (known as clinically isolated syndrome).”1

Clinically isolated syndrome (CIS) refers to a one-time event or episode characterized by symptoms that are related to the loss of myelin (the protective coating that insulates axons, or nerve fibers). For example, this might be experienced as a single attack of optic neuritis. Those with CIS who go on to experience a second clinical attack are typically considered to have clinically definite multiple sclerosis (CDMS).

Early Axonal Damage and Other “Silent” Processes in MS

Researchers are beginning to discover some of the reasons treatment with a disease-modifying therapy may be more effective the earlier it is initiated. Even though someone is newly diagnosed with MS, has experienced just two or three exacerbations, and has mild or no current symptoms, damage, though clinically silent, may still be occurring in the brain. Current research indicates that damage to axons starts very early in the course of MS.2,3

It is believed that the destruction of myelin, which is closely associated with damage to axons, may be the main cause of the neurological problems experienced in MS. When axons are destroyed, the transmission of electrical impulses between nerve cells is interrupted and muscles, organs, and other nerves do not receive the information they need to function properly. Although axonal loss is permanent, symptoms may not be experienced immediately.

Studies also have shown that neurological lesions and brain atrophy (shrinkage of brain tissue) can develop in people with MS who are not experiencing any symptoms or relapses.1

What’s the Evidence for Early Treatment?

The latest results from clinical trials involving MS disease-modifying agents present increased evidence to support the benefits of early treatment. Recently reported data from the Betaseron® in Newly Emerging MS For Initial Treatment (BENEFIT) study found that patients who were treated with Betaseron (interferon beta-1b) were two times better protected against developing MS read more