Could Early Symptoms of MS Be Stratified to Give Better Targeted Multiple Sclerosis Treatments?

Introduction

Multiple sclerosis presents in  various ways   and subsequently shows variable  disease courses. If we knew early on what the disease course for Multiple Sclerosis would be then we could better target the medication in each individual case. To date  it has been unpredictable right from  disease onset but , knowing the disease course is of crucial importance in guiding treatment.

Now “The Department of Neurosciences” at  Cardiff University has recently been looking into factor H as a biomarker for multiple sclerosis and the findings are promising

Effective and accessible biomarkers are needed in order to stratify ( separate into groups)  patients and inform treatment. The team at Cardiff University decided to look into factor H as such a marker.  Regulator factor H, has  recently been implicated as a biomarker in other chronic inflammatory central nervous system conditions. Could it identify or predict specific pathological processes and outcomes in multiple sclerosis?

Method

They measured factor H  in blood serum from 350 patients with multiple sclerosis classified according to disease course and relapse status. Controls were found for variables including disease duration, age, gender, disability and treatment. I have decided not to go into the full method in this document as the details will be somewhat turgid to the average reader. However, the findings are fairly clear and very encouraging.

Results

1) Factor H levels were significantly higher in progressive disease  compared to controls and relapsing patients. Thus factor H levels were capable of distinguishing secondary progressive from relapsing remitting disease (excluding patients in clinical relapse)

2) Acute relapse was also associated with temporarily  increased factor H levels compared to stable relapsing disease.

3) In clinically stable patients, factor H levels remained constant over 1 year  but  in patients in transition from relapsing to progressive disease, factor H levels significantly increased over a period of 2 years . This is a crucial point as the transition between relapsing and progressive signals the need for therapy change.

Conclusion

Serum factor H could  be an effective indicator of progression and a practical and accessible  tool to split patients into groups and to predict  disease course,  Once we have this information we have objective evidence which can help guide therapeutic decisions. As we have known for some time, the earlier you can pick up a disease pattern the better chance of success you have with the treatment.

Tags: disease onset, multiple sclerosis, progressive disease, Treatments, variable disease

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