Immunomodulatory Treatment Improves Cognitive Function in MS Patients

Patients with relapsing-remitting multiple sclerosis (RRMS) who receive glatiramer acetate (GA) or interferon (IFN) beta show a reduction in cognitive impairment and relative stability of cognitive and affective variables at 2 years, according to the results of an observational study presented here at the 19th Meeting of the European Neurological Society (ENS).

The aim of the observational study was to evaluate the long-term effects of first-line disease-modifying therapies with GA or IFN beta on cognitive functions, affective status, fatigue and quality of life in patients with RRMS (ITACA study).

“A total of 752 patients with RRMS and a

mean age of 36 years were enrolled in

79 Italian centres,” explained principal investigator Monica Falautano, PhD, Functional Unit of Psychology, IRCCS H. San Raffaele Milano, Milan, Italy, on June 24.

Study patients were treated with either GA or IFN beta.

At baseline and 6, 12, 18, and 24 months, a fatigue and physical disability evaluation was performed.

Cognitive and affective assessments were performed at baseline and 12 and 24 months.

A significant reduction [P < .0001] in cognitive impairment was observed at the 24-month follow-up, Dr. Falautano noted. At baseline, 40% of all patients showed mild cognitive impairment, and 16% showed severe cognitive impairment, which the researchers said was reduced to 30% and 11%, respectively, at 2 years.

A higher proportion of GA than IFN patients had been affected by severe cognitive impairment (20% vs 12%). At the 24-month follow-up, the percentage of severe impairment was reduced to similar amounts in both treatment groups (12% and 10%, respectively).

According to the mean Montgomery-Asberg Depression Rating Scale score, significant depressive symptoms were missing both at baseline and at the 24-month follow-up.

Physical and mental health assessed with the Multiple Sclerosis Quality of Life 54 questionnaire correlated highly significantly at baseline and at the 24-month follow-up (P < .001).

Patients did not report any changes in perception of their quality of life after 2 years of treatment. No changes were observed in Kurtzke’s Functional Systems Scores.

“The immunomodulatory treatment may have an impact on cognitive function,” Dr. Falautano summarised the primary result of the study. “Nevertheless, a longer follow-up is advisable to confirm our results.”

Funding for this study was provided by Sanofi-Aventis.

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