Drug Widely Used to Treat MS May Not Slow Progression

HealthDay – 3 mins 47 secs ago TUESDAY, July 17 (HealthDay News) -- Interferon beta, a widely used treatment for multiple sclerosis, does not stave off the time to disability, new research finds.

However, prior studies have found that interferon beta does reduce MS flare ups, so patients should continue taking it, researchers said.

The new study is published in the July 18 issue of the Journal of the American Medical Association.

In multiple sclerosis, the body's immune system attacks myelin, or the substance that insulates nerve fibers of the central nervous system. The damage disrupts nerve signals traveling to and from the brain, which can lead to numbness, movement difficulties, blurred vision, fatigue and eventually, problems with thinking and memory.

About 85 percent of those with multiple sclerosis start with a relapsing-remitting course, in which attacks are followed by partial or total recovery, according to the National Multiple Sclerosis Society. More than half go on to develop a more progressive form of the disease, in which symptoms worsen over time and there are fewer, shorter periods without symptoms. Over time, the disease can lead to loss of vision and paralysis.

The study included data on nearly 2,700 multiple sclerosis patients from British Columbia, Canada, with relapsing-remitting MS who were followed for four to 11 years. About one-third of the patients were treated with interferon beta after it became available in the early 1990s and one-third were not treated with interferon beta. The researchers also examined data on a third group of MS patients who were diagnosed and followed before interferon beta was a treatment option.

The investigators found no statistically significant difference in how long it took for patients prescribed interferon beta to become disabled, defined as needing a cane to walk 330 feet.

"We were not able to find a significant association between interferon beta exposure and progression to disability," said Helen Tremlett, an associate professor of neurology at the University of British Columbia.

Most patients with multiple sclerosis, though not all, develop severe disability 10 to 20 years after diagnosis, according to background information in an accompanying editorial. Several studies have suggested that interferon beta, by reducing relapses, could also prolong progression to disability, Tremlett said. Still other research has found that brain scans of people taking interferon beta show less damage.

Though the exact mechanism of how interferon beta benefits multiple sclerosis patients isn't fully understood, the drug acts on the immune system and reduces inflammation.

"What the field pretty strongly believed is if you reduced relapse rate, surely that should translate into beneficial impact on disease progression," Tremlett said. "Subsequent studies seem to indicate there is disassociation between relapses and long-term irreversible disease progression."

Interferon beta is typically given by injection when people are first diagnosed.

That shouldn't change as a result of these findings, said Timothy Coetzee, chief research officer for the National MS Society. The new study doesn't negate prior studies that have found that the drugs reduce the frequency of relapses.

"If patients are taking the existing disease-modifying therapies

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Brain-Injury Recovery Varies Widely Among Children

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) -- Although survival rates for children who sustain brain injuries have improved significantly, it remains difficult to predict how well these children will do in the long term, according to a new evidence review.

The recovery of children with brain injuries is complex, and outcomes may vary widely, the British researchers noted. Protecting these brain-injured children from infections and accidents should be a priority, they said.

The research, published online June 18 in CMAJ: Canadian Medical Association Journal, also found the age at which children sustain a brain injury will have an effect on their recovery. The authors suggested that the common belief that children's developing brains are more resilient may be naive.

"There is no single best approach to describing outcome after acquired brain injury during childhood, and the one chosen must be appropriate to the purpose at hand," Dr. Rob Forsyth, of the Institute of Neuroscience at Newcastle University and Great North Children's Hospital in Newcastle-Upon-Tyne, and colleagues wrote in a journal news release.

The researchers looked at pertinent English-language medical literature from 1966 to the present.

Not enough information is available to help doctors and families decide how to proceed with the children's treatment or, in some cases, withdraw care, the researchers said. Challenges to providing care for children with brain injuries should be considered, as should the cause of the injury.

Outcomes often are better following traumatic brain injuries than injuries sustained from oxygen deprivation, such as drowning or suffocation, the analysis found. The researchers said psychological issues these children may face later on could be masked by the initial recovery of their motor skills.

"Early injury alters the entire developmental trajectory, and effects can compound through childhood," the researchers wrote. "This is particularly clear in the literature surrounding pediatric brain injury, where sometimes impressive early motor recoveries obscure the characteristic emergence of cognitive and psychological

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