Robby: Can DMDs, disease modifying drugs, reduce cognitive decline?
Professor Dawn Langdon, Neuropsychologist: Well, actually we don’t have very much information about that. There’s only a couple of randomised control trials. We always want randomised control trial information. There’s only a couple that tell us about cognition in MS. One of those is from quite a long time ago where they looked at Avonex and they showed that over two years people who were on the drug lost less cognitive function than people who were off the drug. Obviously every trial has some methodological issue, but that was the finding. And the other trial that’s shown an effect is Beta Interferon which was given to patients at CIS, now in the UK we don’t prescribe DMDs at CIS, but they do in Europe. And so in this study people at the CIS stage, the first event, were given the drug and some weren’t, and over a long period of time they showed that the people who were given that drug at CIS, rather than a year or two later, had better information processing speed, so they retained more of that kind of number crunching processing power than the people who hadn’t started the drug so early.
Robby: And any other drugs that help memory?
Professor Dawn Langdon: Well, they’re the only two that we have this very sort of convincing randomised control trial data. Rather sadly I can tell you drugs that don’t work. There’s quite a lot of evidence that, for example, drugs like Donepezil which are used in Alzheimer’s disease for memory, that doesn’t work in MS. And several other kinds of so-called symptomatic drugs, like ginkgo biloba and amphetamines don’t work in MS. So at least that saves you the time and money and the NHS the time and money of prescribing things if they don’t work.
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Professor Dawn Langdon is Professor of Neuropsychology at Royal Holloway University of London, she is co-chair at BICAMS, her other areas of expertise focus on BRIMMS (benefits and Risks of MS medications. She has been the neuropsychological lead on multiple MS trials in the pharmaceutical industry. She is also a trustee of the UK MS Trust.