Treatment at first signs of MS ‘could mean lower risk of disability later’

Symptoms of multiple sclerosis may include fatigue, numbness, tingling, muscle weakness or problems with balance.
The findings support the effectiveness of early treatment for the condition, researchers say (Alamy/PA)
Nina Massey19 July 2023

People who start taking medication soon after the first signs of multiple sclerosis (MS) may have a lower risk of disability later, a study suggests.

Symptoms of MS may include fatigue, numbness, tingling, muscle weakness or problems with balance.

According to the research, starting treatment within six months after symptoms appear is associated with a lower risk of disability over time.

The findings support the effectiveness of early treatment for the condition, researchers say.

Our study found that starting treatment within six months after the first symptoms is associated with a lower risk of disability over time

Alvaro Cobo-Calvo, Autonomous University of Barcelona

In people who have the condition, the body’s immune system attacks myelin, the fatty white substance that insulates and protects the nerves.

The MS Society estimates there are more than 130,000 people with MS in the UK, and that nearly 7,000 people are newly diagnosed each year.

Study author Alvaro Cobo-Calvo, of the Multiple Sclerosis Centre of Catalonia and the Autonomous University of Barcelona in Spain, said: “When it comes to MS treatment, the earlier the better.

“Our study found that starting treatment within six months after the first symptoms is associated with a lower risk of disability over time.”

He added: “Altogether, our results support the robustness and effectiveness of very early treatment to halt long-term disability progression, and stress that earlier detection and treatment is encouraged.”

In the study scientists looked at 580 people with a first episode of symptoms, who received at least one disease-modifying drug.

The group was split into three – 194 people who had their first treatment with an MS drug within six months after the first episode of symptoms, 192 people who had first treatment between six months and 16 months, and 194 people who had first treatment after more than 16 months.

People’s disability levels and brain scans were monitored for damage to the brain and spinal cord from the disease for an average of 11 years.

Disability scores ranged from zero to 10, with higher scores indicating more disability.

According to the findings, the earliest treatment group had a 45% lower risk of reaching a disability score of three by the end of the study than those in the latest treatment group.

This score indicates people can still walk unassisted but have moderate disability in one of eight areas, such as motor function, vision or thinking skills, or mild disability in three or four areas.

A total of 42 people in the earliest treatment group, or 23%, reached a score of three, compared with 75 people, or 43%, in the latest treatment group.

Patients in the earliest treatment group also had a 60% lower risk of moving to the next stage of the disease, called secondary progressive MS, than people in the latest treatment group. In this stage, disability gets steadily worse.

The study, published in the Neurology journal, found that 14 people in the earliest treatment group, or 7%, were diagnosed with secondary progressive MS compared with 43 people in the latest treatment group, or 23%.

People with the earliest treatment were 50% more likely to remain stable at their disease level one year after their initial treatment than those in the latest treatment group, the research suggested.

The study further found that people from the earliest treatment group had a lower disability progression rate and lower severe disability in a self-reported test compared with those in the latest treatment group.

However, the researchers highlight that their study only included patients between ages 16 to 50 at the time of first symptoms, so the results could not be applied to patients over age 50, or late-onset multiple sclerosis.

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