Drug Experiment Sharply Reduces MS Disabilities
An experimental drug may delay the debilitating effects of multiple sclerosis in patients who are still only mildly affected, according to results of a cautiously worded pilot study announced today.
In an experiment involving 48 patients, the test drug markedly decreased the number of multiple sclerosis attacks over a two-year period and appeared to reduce the extent of disability in some of the patients, said the researchers from Albert Einstein College of Medicine in New York.
For the record:
12:00 a.m. Aug. 16, 1987 For the Record
Los Angeles Times Sunday August 16, 1987 Home Edition Part 1 Page 2 Column 1 Metro Desk 2 inches; 48 words Type of Material: Correction
An Aug. 13 Times story about a new experimental drug against multiple sclerosis erroneously stated that the most common type of MS can result in death. In fact, this type of MS is not considered life threatening. MS is a neurological disease that results in loss of coordination, weakness, blurred vision and other neurological impairments.
Their report, and an accompanying editorial in the New England Journal of Medicine, emphasized that other experimental drugs also have shown early promise that faded when larger studies were conducted.
At this point, the chief difference between the new test drug, COP 1, and the others is that COP 1 appears to be far less toxic, according to Dr. Murray B. Bornstein, the principal investigator.
He said more definitive tests must be conducted before firm conclusions can be drawn about its possible effectiveness.
Multiple sclerosis is a neurological disease that is believed to result when the body’s immune system attacks the myelin sheathing that surrounds nerve fibers in the brain and the spinal cord. Destruction of the myelin blocks the transmission of nerve impulses, causing loss of coordination, weakness, blurred vision and eventual death.
Bornstein said COP 1, developed in Israel, appears to work by causing the body to activate certain cells in the immune system that block the process that destroys the myelin.
In about 70% of the 250,000 cases of multiple sclerosis in the United States, the patient goes through periods in which the symptoms become more severe, followed by periods of recovery. Typically, these patients can be expected to have relapses several times a year, and the cycles may continue for many years until death.
The other 30% of multiple sclerosis patients experience a steady progression of symptoms without remission.
The New York study involved only patients with the cyclic type of disease.
Of 48 participants, 25 received COP 1 and 23 received a placebo. In the first group, 14 had no exacerbations, or relapses, during the two years of the study--compared to six in the second group, according to Bornstein.
Some Showed Improvement
In the study, there were 62 relapses among the 23 patients on the placebo--the range was from zero to eight exacerbations each--compared to 16 relapses among the 25 taking COP 1.
Bornstein said several of the least disabled patients in the treatment group at the beginning of the study had improved by the end of the study, although patients with a similar level of disability in the placebo group were more disabled by the study’s end.
The researcher noted that the evaluation of a drug’s efficacy is exceedingly difficult because of the disease’s tendency to cripple patients temporarily, only to regress to near normal without any drug therapy.
An important feature of COP 1, Bornstein said, is that the drug produced no serious side effects during the two years that patients took it by injecting it daily under their skin. The absence of strong side effects contrasts with other experimental treatments of the disease, he said.
Other experimental drugs for multiple sclerosis are known to cause damage to the liver, kidneys, bone marrow or other organs.
According to Dr. Emanuel Standlin, a deputy director of the National Institute of Neurological and Communicative Diseases and Stroke, which funded the study, a number of clinical studies are under way to test the efficacy of several other new approaches to treating multiple sclerosis.
One such study on patients with the chronic progressive type of multiple sclerosis uses cyclosporin, a drug that is widely used to prevent recipients of organ transplants from rejecting the transplant. Other studies involve steroid drugs, interferon, monoclonal antibodies and the use of radiation--all aimed at stopping the immune system from destroying the sheathing around nerves.
“One of these days there will be a treatment, and it will be effective in arresting the progress of that illness,” Standlin predicted.
