Drug reboots immune system to reverse MS

时间:2017-09-03 07:00:21166网络整理admin

By Andy Coghlan For the first time, a drug has successfully reversed nerve and brain damage from multiple sclerosis, trial data suggests. “This is unprecedented,” says Alasdair Coles at the University of Cambridge, UK, who coordinated a trial that found that the drug alemtuzumab blocks progress of multiple sclerosis. MS disables nerves and brain tissue by attacking the myelin sheaths that otherwise protect them from damage. “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 and night,” commented Lee Dunster, head of research at the UK MS Society. Alemtuzumab is a monoclonal antibody that has been used since the 1980s to treat chronic lymphocytic leukaemia. Coles and his colleagues conducted the trial with 334 patients in the early stages of multiple sclerosis. Half the patients received alemtuzumab and the other half interferon beta-1a, the standard treatment for MS. The patients were then followed for three years. Alemtuzumab completely outperformed the rival drug, reducing the number of relapses by 78% over and above that achieved with interferon. It also reduced by 71% the risk of patients developing a disability. Magnetic resonance imaging brain scans showed that brain lesions disappeared, and that the brain volume of patients on alemtuzumab grew, while those on the rival treatment shrank. Likewise, patients on alemtuzumab scored higher than before the treatment on a standard disability scale, whereas patients on interferon gradually deteriorated. One patient on alemtuzumab, for example, resumed playing professional golf after three years on the treatment. Tony Johnson is now back and winning tournaments. The treatment works by destroying all the patients’ lymphocytes, the T-and B-cells that normally fight infections, but which mistakenly attack nerves and brain tissue in MS patients. Following the treatment, the immune system grows back, but without the cells that cause MS. “It’s as though you’ve re-booted the immune system, so it’s better behaved,” Coles says. The whole process takes about three to four years, adds Coles, who is hopeful that the drug might also be able to help patients with other auto-immune diseases such as diabetes and lupus. Patients with alemtuzumab did suffer side effects, however, including damage to blood platelets – which help the body form clots to stem bleeding – and damage to thyroid function. But Coles says both are manageable with other drugs. Surprisingly, though, given that protective white blood cells were destroyed, patients didn’t seem more prone to infections. The other benefit of alemtuzumab is its relative ease of delivery. Whereas patients have to inject themselves weekly with interferon, alemtuzumab was given once at the start, through four-hour infusions on five successive days, then 12 months later over three days. So brief and occasional treatments can bring benefits for two to three years. “It’s much more effective and is easier to administer,” says Coles, although it does have more side effects, which the team are aware of and are working to reduce. Two large studies have now begun to prove definitively whether alemtuzumab works, but it will be four years before the results are known. Coles says that patients interested in participating can contact Genzyme, the company sponsoring the trial, by emailing: [email protected] Journal reference: New England Journal of Medicine (vol 359, p 1786) Mental Health – Discover the latest research in our continuously updated special report. More on these topics: