Experts are urging newly-diagnosed Multiple Sclerosis (MS) patients
to take a "close observation by their doctors" approach
to treatment. Patients also advised against taking medication for
the first few years of the disease, according to a Mayo Clinic study.
In the past, doctors traditionally encouraged MS victims to take
a proactive approach by starting prescription treatment in case
of a future attack. However, the Mayo research suggests that doctors
and patients could hold off for a few years in order to monitor
the disease's progression.
Researchers said this is because their results indicate that the
longer the duration of the disease and the lower the level of disability,
the more likely patients are to remain stable and not get worse.
There are cases of benign MS, one researcher said, adding this can
be identified during analysis of a patient, even at the five-year
mark.
Study organizers called the news a big break.
These findings will potentially impact the 17 percent of all U.S.
MS patients who have benign cases of the disease. Researchers suggest
that there are about 70,000 benign MS patients, assuming the total
of MS patients in the United States to be 400,000.
Patients with benign MS are defined as having had the disease for
10 years or more with a low level of disability. This is measured
by the Expanded Disability Status Scale (EDSS), which ranges from
zero (a normal neurological exam) to 10 (death due to MS). Benign
MS patients register a score of two or less because they have less
than 10 percent likelihood of developing a significant disability
in the future. To further clarify the scale, a score of four indicates
a patient has moderate disability but is able to walk unassisted;
a score of six means the patient is dependent on some type of assistive
walking device, while those that need wheelchairs register a score
of eight.
Researchers said benign MS patients often describe themselves as
normal. However, they still can experience attacks but it is unlikely
they will lead to permanent disability. One doctor said a bad attack
might cause a problem, such as vision loss in one eye, but only
temporarily. The symptoms seem to come and go, but most of the time
there are no visible signs of the disease.
Study Results:
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Only 7 percent of MS patients who score a 2 or less will, after
10 years, progress to a greater level of disability (score of
four)
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Not one of those patients needed a wheelchair, even after 20
years with the disease
-
MS patients who, after 10 years, had an EDSS score of 2.5 to
4 were more likely to reach a greater level of disability
-
After 20 years with MS, 12 of 21 patients in this situation
registered score greater than four.
Mayo Clinic experts said that while this study confirms past data,
it seriously challenges many doctors who do not believe MS can be
benign. It is the common course of action to begin interferon drug
therapy, with immunomodulatory medications, as soon as possible,
for as long as possible, instead of observing the natural course
of the disease.
EurekAlert
August 30, 2004
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