Aggressive, Early Disease-Modifying Therapy May Slow MS Progression

FRIDAY, Sept. 27, 2024 (HealthDay News) -- Reducing or preventing paramagnetic rim lesions (PRLs) could significantly slow multiple sclerosis (MS) progression, according to a study presented at the annual meeting of the American Neurological Association, held Sept. 14 to 17 in Orlando, Florida.

Jack Reeves, Ph.D., from State University of New York at Buffalo, and colleagues assessed the relationship between new PRL appearance, disappearance, or persistence over five years and the prevalence of confirmed disability progression (CDP) and progression independent of relapse activity (PIRA). The analysis included 93 people with MS who had 3T magnetic resonance imaging at baseline.

The researchers found that significantly increased odds of CDP were associated with the number of persisting PRLs (exp(β) = 1.24). There was also a significant association between increased odds of PIRA occurrence and number of persisting PRLs (exp(β) = 1.35) and the presence of newly appearing PRLs (exp(β) = 8.68). Reducing the number of persisting PRLs to zero in people with MS and at least one baseline PRL (PRL+) would result in an estimated 45.6 percent relative reduction in five-year PIRA prevalence (26.1 to 14.2 percent of PRL+) and a 27.1 percent relative reduction in five-year CDP prevalence (30.4 to 22.2 percent of PRL+). Completely preventing new PRLs in the whole cohort would result in an estimated 14.0 percent relative reduction in five-year PIRA prevalence (22.9 to 19.7 percent).

"Our data suggest that development of novel disease-modifying therapies that efficaciously target ongoing chronic active inflammation would significantly reduce the burden of clinical disease progression in the MS population," the authors write.

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