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agate
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 Posted: Thu Oct 05, 2006 6:12 pm Post subject: (Summary) Early treatment for MS? |
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The current issue of Inside MS (October-November 2006) contains a summary of a debate that took place in the American Medical Association's Archives of Neurology in the April 2006 issue (a special section).
The article published input from two international panels, one led by Elliot Frohman, MD, PhD, of the University of Texas Southwestern Medical Center at Dallas, and the other led by Sean J. Pittock, MD, of the Mayo Clinic, Rochester, MN. Dr. Frohman is a member of the National MS Society's National Medical Advisory Board.
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Dr. Frohman and his co-authors, in their article, "Most Patients with Multiple Sclerosis or a Clinically Isolated syndrome Should Be Treated at the Time of Diagnosis," pointed out that data show:
Most people with MS will develop significant disability over time, and early on it is impossible to determine if a person's course will be benign.
Studies suggest that injury to nerve fibers--which leads to the progression of disability--begins early in the course of the disease.
The FDA-approved MS treatments decrease the number and severity of relapses, the number and size of new MS lesions, and the progression of disability (such as loss of vision, mobility, or cognitive ability).
The treatments work best earlier in the course of the disease.
Delaying treatment has been associated with more disability and a larger volume of MS damage as seen on MRI.
Dr. Pittock and co-authors, in "Not Every Patient with Multiple Sclerosis Should Be Treated at Time of Diagnosis," countered that research indicates:
If left untreated, MS often runs a "favorable" course, but it is difficult to distinguish a favorable course from a treatment success over time.
The approved treatments are only partially effective in the short term.
It is not proven that the treatments prevent disability over the long term.
Treatments are expensive, ranging from about $16,000 to $28,000 a year. Moreover, they have adverse effects, and the interferons can become ineffective if neutralizing antibodies develop.
In an editorial, E. S. Roach, MD, of Wake Forest University School of Medicine, judged the debate.
"One approach," Dr. Roach wrote, "is to defer treatment until the patient's course is better established, possibly allowing those with less aggressive disease to avoid years of unnecessary treatment. But most people with newly diagnosed MS do progress, and we must consider that treatment could be less effective if started later."
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lady_express_44
Joined: 22 May 2006
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Location: Vancouver, Canada
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| Posted: Thu Oct 05, 2006 11:31 pm Post subject: |
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Great pro's and con's.
Which to believe though? <sigh>
Cherie
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You can tell whether a man is wise by his questions.
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agate
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| Posted: Fri Oct 06, 2006 8:43 am Post subject: |
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| One way to look at it might be to say, "I have MS, which is already doing strange things to me. If I add a medicine, that medicine is capable of doing some more strange things to me. That would just make my problems more complex. Every time something strange happened to my body, it would be hard to know if it was the MS acting up, or the new medicine I've been taking. If I don't take any new medicine, the whole process of figuring out what is causing my problems is simpler." |
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lady_express_44
Joined: 22 May 2006
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| Posted: Fri Oct 06, 2006 9:43 am Post subject: |
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The other side is "I could be much worse off if I did nothing" ("and I'll kick myself in the ass if I don't do everything possible..."). That's mostly just a guilt complex/marketing ploy in my mind though.
I haven't done any of the mainstream disease modifying drugs so I can't comment on their effectiveness on me. I suspect they do help some people, but I am not sure that that isn't more a matter luck then design.
The stats aren't great either. In fact, I don't think they even know what needs to be controlled (i.e. are relapses a bad or good thing?) so that we may actually better off in the long run. 
I don't like taking drugs, and it isn't a MS-specific phobia. So, admittedly I am dubious about all drugs, even before I start my research to determine if they might be right for me.
I am just not impressed by our options.
Cherie
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agate
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| Posted: Fri Oct 06, 2006 1:24 pm Post subject: |
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Cherie, you said:
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| The other side is "I could be much worse off if I did nothing" ("and I'll kick myself in the ass if I don't do everything possible..."). That's mostly just a guilt complex/marketing ploy in my mind though. |
I was probably strongly influenced by this kind of thinking when I opted to take Avonex.
A wee small voice was saying to me, "None of these drugs has been around long enough for anyone really to know what they might do to a person." I let that voice be silenced long enough to take Avonex for 3 years, though... |
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