Wednesday, June 16, 2010

MethotrexateImage via Wikipedia
Intrathecal methotrexate treatment may help stabilize progressive MS
Submitted by hollie on Tue, 2010-06-15 12:54. Research

Although clinical research in MS seems to be at an all-time high level of activity, this activity remains heavily concentrated on relapsing-remitting MS as opposed to progressive forms of MS. This is understandable -- relapses can be reduced by manipulating cells circulating in the immune system, and there are many ideas for ways to manipulate these cells. However, the need for therapies is much more urgent for people with progressive MS.

Recognizing this need, a team of researchers at the Multiple Sclerosis Research Center of New York recently conducted a treatment study involving methotrexate administered intrathecally (in the spine). Methotrexate is one of many cancer-fighting agents that have been investigated in MS because of their effect on immune cells. Usually it is taken orally, but an intrathecal version is available to treat leukemia in cerebrospinal fluid. Injecting methotrexate intrathecally gets it past the blood-brain barrier and closer to the scene of disease activity.

In this study, 87 subjects with secondary progressive MS and 34 with primary progressive MS received up to 8 treatments given every 8 to 11 weeks. Each subject was evaluated a year after their last treatment using the EDSS scale. The SPMS group had a lower average EDSS score at the end of the study compared with their starting score, with 89% of the subjects either improving or staying the same. In addition, 82% of the PPMS subjects had no significant progression. Importantly, no serious side effects were observed.

There are several drugs in the MS pipeline that are thought to have neuroprotective effects and thus may improve the health of people with progressive MS. While we wait for those drugs to be brought to market, perhaps intrathecal methotrexate should be studied more extensively since it's available now and has the potential to help people with progressive MS.

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