What are the first signs of MS

At what point does it make sense to start drug therapy at the first signs of multiple sclerosis (MS)? As soon as the first symptoms such as balance disorders, numbness, reduced strength or impaired vision appear? Or only when the disease has been effectively diagnosed? So far, only studies with observation times of a few years have been available to clarify this question. This is relatively short for a disease that lasts on average for several decades. Now, however, an international long-term study, in which researchers from the MS research group at the University and the University Hospital Basel (USB) were in charge, clarifies the long-term effects of starting treatment early.

Head of the study, Prof. Ludwig Kappos, head of neurology at the USB: “Our study encourages us to urgently recommend preventive therapy to those affected the first time they experience highly suspicious MS symptoms. Starting treatment early has demonstrable advantages over delayed initiation of therapy because it can delay or even prevent the onset of MS. "

Early therapy is worth it

The study enrolled 468 people with the first suspicious symptoms of MS. Although they had not yet made a definitive diagnosis of MS, other causes could be ruled out and at least two asymptomatic foci could be detected in the MRI. After the information and consent had been given, the participants were randomly assigned either the drug interferon β-1b or a placebo within a maximum of 60 days from the onset of symptoms. After two years at the latest, or earlier, if the person was diagnosed with MS after a second attack, the placebo group could also switch to taking interferon β-1b or a comparable drug.

Eleven years after the start of the study, the researchers were able to examine 278 study participants in detail. Of these, 167 people were in the early therapy group and 111 people were in the delayed therapy group. It showed that the people from the group with early therapy had a 33 percent lower probability of developing MS than those from the group with later therapy. In addition, significantly more time elapsed in the early group until the first relapse of the disease, namely 1,888 days compared to 931 days in the later group.

The early group had a 19 percent lower frequency of disease flare-ups over the entire eleven years, interestingly usually also in the years in which both groups had equal access to therapy. Overall, both groups had little permanent impairment after eleven years. The median change in the EDSS, a ten-point disability scale, was 0.5 points and only around eight percent of the participants took early retirement after eleven years.

Publication in «Neurology»

The results of the study were published on August 10, 2016 in the renowned journal “Neurology” of the American Academy of Neurology and were particularly highlighted by the editor. Hospitals and universities from Belgium, Denmark, Germany, Finland, France, Great Britain, Israel, Italy, Canada, the Netherlands, Norway, Austria, Poland, Portugal, Sweden, Slovenia, Spain, the Czech Republic, Hungary and Switzerland were involved in the study

At the Neurological Clinic and Polyclinic of the USB, a multidisciplinary team offers specialized diagnostics, advice and therapy for multiple sclerosis and related diseases, as well as researching new diagnostic, medicinal and non-medicinal treatments. Multiple sclerosis is a chronic inflammatory and degenerative disease of the central nervous system that mainly affects young adults and affects more than two million people worldwide.

Further information on the study, originally entitled “The 11-year long-term follow-up study from the randomized BENEFIT CIS trial” can be found here: http://www.neurology.org