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Lesions looking less and less important
Submitted by art on Fri, 2008-08-01 07:57.
This study looking at white matter fiber tracts in the brains of people with MS has found that the atrophy of these tracts seems to be independent of lesions, implying a more diffuse process at work. Yet more evidence that MS is not a focal disease and that our measures of treatment efficacy surrounding lesion activity may not be the best.
It has been known for a long
It has been known for a long time that the number of lesions do not correlate with MS symptoms. The atrophy aspect of the disease make more sense to me as a better measure of disease progression.
Pharmas will still use the less than perfect system of lesion load to show the efficacy of their products.
While lesion load may not be
While lesion load may not be perfect, it is the best "short term" tool available for evaluating drug efficacy in clinical trials. While atrophy may indeed be better, it has to be measured over a longer period, delaying and slowing down the drug development and approval process. So it is a tradeoff between speed to market for these drugs and better but longer term measures. Personally, I would rather have a few partially effective drugs on the market sooner than wait a decade or longer to get the data needed for that one knockout drug that may or may not come to fruition. Besides, there is some correlation between lesions and atrophy, see the related links on the right when you click on the study link that strarted this string.
Your presented choices
Your presented choices (partially effective/now vs more effective/later) need not be mutually exclusive. I'd rather have more effective drugs now. So let's start measuring things that matter. The evidence is growing that lesion burden isn't that clinically relevant (though obviously, fewer lesions is better).
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Art Mellor, Accelerated Cure Project for MS, art-msnews -at- acceleratedcure.com