Claire asks Anna how effective is chemotherapy as a treatment for MS?
And is there any evidence of people developing symptoms post the treatment, developing sort of new MS symptoms, do you know?
So I looked this up yesterday, because it’s not a trial I’m involved in, but the Sheffield trial was saying that 80% of people at four years hadn’t had a relapse. That’s really good. It does mean that 20% of people did.
That’s still good, yeah.
Yeah. So it’s not perfect. But, you know, it’s a good start and I think it’s like any drug trial, nothing is perfect and you have to say well, okay, who are the people who benefit most, who are the people who are more risky. And I think that’s the other thing to make sure, and it’s very clear on the Sheffield website, is that it didn’t work for people with progressive MS.
Did it not?
No. That was very clear. And in a way that makes sense, because we know that the immune system is most involved early on, in the relapsing remitting stage, and that’s where you need to suppress your immune system, that’s where all the drugs do, they all suppress the immune system in different ways and that’s what the transplants are trying to do. But we know that when you get to the progressive side of MS, the inflammation is less important, the immune system’s less important and it all seems to be related to the nerves themselves dying back and that’s where we want to do the myelin repair side of things, because if we can then put the myelin back on the nerves that will hopefully stop them from dying back and stop people getting worse in their disability. And so it will end up, in my view, as a two-pronged attack on MS patients.
So initially with immune system modulators, whether they are drugs or stem cell transplants, and then later on, it will be the myelin repair side of things. They may overlap. We may end up with a time logging on both so that you can suppress the immune system and repair your brain in two different ways. And I think we’re doing much better at the first bit and we are getting there with the second bit. It gets much more exciting, lots of drugs now going into trial for that side of things, but as I said, difficult to measure, difficult to do, because we have to get the drugs into the brain. The immune system, you don’t need to, because the white cells are travelling round your blood, so as long as it gets into the blood, you’re fine. But in this one, completely different and should be seen as a separate therapy, I think. Immune therapies, repair therapies. And I say, you may well be on both as an MS patient, ultimately, but attacking two different bits of the disease, is my prediction.
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MS Reporter: Claire
MS Expert: Dr Anna Williams works in research and is an Honorary Consultant Neurologist, at the Centre for Regenerative Medicine at Edinburgh University, she researches why remyelination fails in MS and what can be done to improve its efficiency.