MedicalResearch.com Interview with:
Tomas Kalincik, MD, PhD, PGCertBiostat
Neurologist and Senior Research Fellow
Melbourne Brain Centre | Department of Medicine | University of Melbourne
Department of Neurology | Royal Melbourne Hospital
Melbourne | Victoria | Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Multiple sclerosis is a disease predominantly of young adults, with the peak of incidence in the 3rd and 4th decades. It is the most common cause of neurological disability in young adults. Only in Australia, 23,000 people are living with MS, with MS representing an annual cost of almost 1 billion $AU to the Australian society. It is a disease that presents with broad range of neurological symptoms and signs, which are typically temporary (these are called relapses) that with time can lead to permanent neurological disability. While there is currently no cure for MS, with appropriate therapy, its symptoms can be controlled and the disability progression slowed down.
MedicalResearch.com: What should readers take away from your report?
Response: There are a number of treatment options for multiple sclerosis. These options vary both in their efficacy and safety. The present study showed that a highly effective therapy alemtuzumab, a recently introduced immunotherapy for MS, an efficacy that is similar to another highly effective therapy natalizumab. Our study was completed as part of a large global MS collaboration called MSBase, involving more than 120 multiple sclerosis centres in 35 countries and comprising data from 45,000 patients. The study included almost 4000 eligible patients treated with either natalizumab or alemtuzumab. Patients exposed to either therapy had very similar chance of experiencing relapses (approximately 1 relapse every 5 years) and progression of disability (progressing approximately once every 10 years). During the first year of treatment, the chance of recovering from disability was greater among the patients who were treated with natalizumab than in those treated with alemtuzumab.
The results of our study show that for patients with active multiple sclerosis, there are now multiple treatment options available. This provides patients and their neurologists with a better chance to effectively control the disease.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Further research should evaluate long-term disability outcomes among patients treated with highly effective multiple sclerosis therapies. Effective prevention of disability is the ultimate goal of the current MS immunotherapies. We also need to learn more about the effect of these drugs on subclinical disease activity – such as brain and spinal cord lesions – comparing their effects using MRI. Finally, in order to provide clinicians with a complete picture, comparison of safety profiles of natalizumab and alemtuzumab is important.
MedicalResearch.com: Is there anything else you would like to add?
Response: Large observational cohort studies such as MSBase are a valuable source of information which otherwise can not be obtained from randomised clinical trials. However, these studies should be done with caution and using careful statistical designs, as they are vulnerable to many different biases.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Treatment effectiveness of alemtuzumab compared with natalizumab, fingolimod, and interferon beta in relapsing-remitting multiple sclerosis: a cohort study
Published:10 February 2017
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