NEW study data has indicated haematopoietic stem cell transplants may delay disability longer than other multiple sclerosis (MS) medications in those with active secondary progressive MS (SPMS). Initial diagnosis of MS is often relapsing-remitting MS, which is characterised by symptom flare-ups and followed by periods of remission, which often transition into SPMS instead, synonymous with a slow, steady worsening of the disease.
The retrospective study analysed 79 patients with active SPMS who received autologous haematopoietic stem cell transplants and compared outcomes with 1,975 individuals from the Italian MS registry who were treated with MS drugs. The drugs that the registry patients were treated with included, β-interferons, azathioprine, glatiramer, acetate, mitoxantrone, fingolimod, natalizumab, methotrexate, teriflunomide, cyclophosphamide, dimethyl fumarate, and alemtuzumab.
“Haematopoietic stem cell transplants have been previously found to delay disability in people with relapsing-remitting MS, but less is known about whether such transplants could help delay disability during the more advanced stage of the disease,” explained study author Matilde Inglese, University of Genoa, Italy.
MS progression was measured through measuring participants disability with the Expanded Disability Status Scale (EDSS), which ranges from 0 (no symptoms) to 10 (death due to MS). Participants were assessed sporadically over 10 years. At the beginning of the study, both study groups had a median score of 6.5. After 5 years analysis showed than 62% if individuals treated with stem cell transplant had experienced no worsening of symptoms compared to 46% of those on the various medications. The researchers further found that 19% of the individuals treated with stem cells were experiencing less disability than at the start of the study compared to just 4% of people taking medications.
“Our study shows that haematopoietic stem cell transplants were associated with a slowing of disability progression and a higher likelihood of disability improvement compared to other therapies. While these results are encouraging, they are not applicable to patients with SPMS, who do not have signs of inflammatory disease activity; more research is needed in larger groups of people to confirm our findings,” summarised Inglese.