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MS Pills Show Promise and Risk, Studies Say

MS Pills Show Promise and Risk, Studies Say

Associated Press

January 21, 2010

ATLANTA – Tests of the first two oral drugs developed for treating multiple sclerosis show that both cut the frequency of relapses and may slow progression of the disease, but with side effects that could pose a tough decision for patients.

Two experts not involved in the studies said the drugs appear effective but with potentially dangerous side effects. It’s too soon to know if the pills will be approved by the government or widely adopted by physicians, they said.

About 2.5 million people around the world have multiple sclerosis, a neurological disease that can cause muscle tremors, paralysis and problems with speech, memory and concentration. The studies involve the most common form of the disease, in which people are well for a while and then suffer periodic relapses.

Current treatments can reduce the duration and severity of symptoms but require daily or regular shots or infusions.

The new studies tested two types of pills. Cladribine, made by Merck Serono, is already sold to treat a rare blood cancer. For MS, it would be taken eight to 10 days a year. Fingolimod is a daily MS pill being developed by Novartis.

The research found that patients on the pills were about half as likely to suffer relapses of symptoms as those who took dummy pills or a commonly prescribed shot for MS.

But they also found both drugs significantly lowered immune defenses that allowed latent herpes viruses to rage in some patients — in one study, two people died of unchecked herpes infections.

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The side effects detailed in the new studies are giving some physicians pause.

“There is a price tag attached” to the new medications, said Dr. Silva Markovic-Plese, an MS researcher at the University of North Carolina.

The studies were being published in Thursday’s New England Journal of Medicine.

There is no cure for MS, but steroids can reduce the duration and severity of symptoms in the short term, and seven treatments on the market have had success in reducing recurrence of symptoms.

All involve daily or regular injections. So a pill is appealing: Even healthy people can have trouble giving themselves shots, so it can be a nightmare for patients with faltering coordination and concentration.

“Right now I have to think very hard when I make coffee,” said Ivana Vuletic, a 49-year-old Chapel Hill, N.C. woman with MS. “I would be greatly relieved if I didn’t have to prick myself or be pricked” with needles, she said.


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