MS patients not receiving medications to slow disease progression

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Neurologists at Wake Forest University Baptist Medical Center have found that many patients diagnosed with multiple sclerosis (MS) are not taking or being prescribed drugs approved to treat the disease.

"When we looked at patients who are being seen by family practitioners and by neurologists, we were surprised at the number of people who are not benefiting from drugs proven to help reduce the side effects of MS," said Cormac O'Donovan, M.D., a neurologist and co-investigator of the study. "Hopefully by educating physicians about the benefits of these drugs and beginning treatment early, we can slow the progression of this disease."

O'Donovan's research was published this month by Biomed Central.

O'Donovan and his team studied patient visits to family practitioners, neurologists or internists between 1998 and 2004 across the United States. There were an estimated 6.7 million MS patient visits to physicians during this time. Neurologists recorded the most patient visits (50.7 percent).

About 62 percent of patients visiting neurologists and 92 percent seen by family practitioners/internists were not using immunomodulatory agents (IMAs), according to the research. Treatment with IMAs is known to reduce the frequency of relapses and slow disease progression.

Six IMAs have been approved by the U.S. Federal Drug Administration (FDA) for use in treating MS. They are: interferon-1b (sold under the name Betaseron), interferon-1a (Avonex), glatiramer acetate (GA or Copaxone), interferon-1a (Rebif), mitoxantrone (Novantrone) and natalizumab (Tysabri).

"Our study could not determine exactly why these FDA approved drugs were not being prescribed for the treatment of MS," O'Donovan said. "Some individuals may have mild symptoms at first and decide to defer treatment. Other factors may be that physicians are not as familiar with the newer drugs on the market and the risk-to-benefit ratio. Some patients may not even be aware of the pros and cons of IMAs or were advised by their physician that they did not meet the criteria for taking the drug. The increased use of IMAs by neurologists probably reflects greater awareness of the drugs' availability and their use by specialists who more often treat patients with MS. We need to spend some time looking further into the issue."

MS is an inflammatory disease of the central nervous system. It is the second most common cause of neurological disability in young adults. The cause of MS is unknown but environmental factors and genetics are thought to contribute to the onset of the disease.

Data for this research was obtained from surveys conducted annually by the National Center for Health Statistics and the Centers for Disease Control and Prevention.

Researchers on O'Donovan's team included: Fabian Camacho, M.S., Steven Feldman, M.D., both of Wake Forest Baptist; and Jagannadha Avasarala, M.D. of Kansas Neurological Consultants and Steven Roach, M.D. with Ohio State University Medical Center, who were at Wake Forest Baptist at the time of the research.

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