HOW EFFECTIVE ARE DISEASE-MODIFYING DRUGS IN DELAYING PROGRESSION IN RELAPSING-ONSET MS?

Abstract

I read the article by Brown et al. who estimated delay of progression of disability in patients with multiple sclerosis (MS) treated with disease-modifying drugs (DMDs).1 Data indicating delay of progression utilizing patients treated with disease-modifying treatments as their own controls and comparing treated and untreated stages of the illness cannot provide the same significance as data from matched placebo-controlled studies of such medicines, which have only indicated trends toward significant effects on delay of progression of disability and not a robust effect of treatment. Matched placebo-controlled trials of disease-modifying medicines are more likely to determine the effect of disease-modifying treatment on progression of disability, although the authors have described their information as real-world effectiveness, based on their experiences in clinical practice. Reviewing their article, there was little effect of treatment on secondary progressive MS; however, table 1 indicated that such patients were much more disabled, Expanded Disability Status Scale (EDSS) scale of 4.64 at time of first injection, than the relapsing remitting patients, …