Study Finds Early Drug Treatment May Slow Down MS Development

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system such as the brain, spinal cord, and optic nerves, according to the National Institute of Neurological Disorders and Stroke. MS occurs when the immune system mistakenly attacks the protective covering of nerve fibers, called myelin, causing inflammation and damage to the nerves. The onset of MS can begin in early adulthood between the ages of 20 and 40. Although there isn't a cure for MS, injectable treatments, infusions, and oral medications can reduce the inflammation response and treat flare-ups.

One medication used to treat MS is teriflunomide, and a 2023 clinical trial investigated how it might slow the brain abnormalities that show early signs of MS. The results of the trial will be presented at the American Academy of Neurology's annual meeting next week. The study recruited 89 adults whose MRI scans showed radiologically isolated syndrome (RIS), a condition in which someone has the same lesions on the brain and spinal cord as MS without having MS symptoms, according to a news release. Many, but not all, patients diagnosed with RIS will go on to develop MS (via Cedars Sinai). 

In the study, half of the people took 14 milligrams of teriflunomide while a control group took a placebo. After two years, eight people who took teriflunomide developed MS compared to 20 in the placebo group. This shows the drug could reduce the risk of developing MS by 72%.

What is known about MS and RIS

Although researchers don't know what causes MS, studies in immunology, epidemiology, genetics, and infectious agents like viruses are looking into what factors contribute to its onset, according to the National Multiple Sclerosis Society. About one million people in the United States live with MS. MS is more common in women than men, as well as in people of northern European descent. Low levels of vitamin D, smoking, and obesity also factor into the likelihood of developing MS. Symptoms include muscle weakness, fatigue, coordination problems, numbness or tingling, vision problems, and cognitive impairment, and these symptoms can progress over time. However, some people with MS might have mild symptoms while others might experience severe disability.

Cedars Sinai says that RIS is typically found in an MRI scan for other conditions such as migraines or head trauma. After two years, one-third of people with RIS patients can develop MS. However, one-third of people won't see any further development.

Study author Christine Lebrun Frenay, MD, of the University Hospital of Nice in France and a Fellow of the American Academy of Neurology, said in the release that MRI scans can detect RIS earlier. "The sooner a person can be treated for MS, the greater the chances of delaying damage to the myelin, which decreases the risk of permanent neurologic impairment and debilitating symptoms," she said.