An MS battle plan

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Biology of MS

In February, a team led by Dr. Stephen Hauser of UCSF reported in the New England Journal of Medicine that in a 48-week trial of 104 patients, rituximab halved the number of patients experiencing relapses relative to a placebo. "It's led to a whole new understanding of the biology of MS," Green says. "There are now a ton of potential therapies that are going to be B-cell directed."

But the downside of taking powerful modulators of the immune system are their serious side effects, including making patients more susceptible to infections and other chronic diseases. Two patients died after taking fingolimod, one with a brain infection and the other with shingles.

And in the alemtuzumab trial published in October, researchers reported that one-quarter of the patients developed an autoimmune disease attacking the thyroid and three developed an autoimmune disease of the blood platelets.

"Drugs like this are toxic," Voskuhl says. "It's a hard sell to people who are very young to expose them to drugs that have dramatic side effects."

A larger problem with the current slate of therapeutics is that they address only the inflammation side of the disease. "But we now know for sure that neurodegeneration is not just caused by inflammation," Centonze says.

As excited as he is about the burgeoning treatment options, he says, "Before judging the real quality of these drugs, you must treat many, many patients for several years."

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health@latimes.com

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To get help

For more information, go to the National Multiple Sclerosis Society website at www.nationalmssociety.org or call the group's Southern California chapter at (800) 344-4867.