Slowing of disability progression and higher likelihood of disability improvement observed compared with standard disease-modifying therapies
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Dec. 28, 2022 (HealthDay News) — For patients with active secondary progressive multiple sclerosis (SPMS), autologous hematopoietic stem cell transplantation (AHSCT) is associated with a slowing of disease progression compared with other anti-inflammatory disease modifying therapies (DMT), according to a study published online Dec. 21 in Neurology.
Giacomo Boffa, M.D., from the University of Genoa in Italy, and colleagues compared the effect of AHSCT to that of DMTs on long-term disability worsening in active SPMS. Worsening disability was assessed by the cumulative proportion of patients with a six-month confirmed disability progression (CDP) according to the Expanded Disability Status Scale (EDSS) score. Data were included for 79 AHSCT-treated patients and 1,975 patients with other DMTs.
The researchers found that time to first CDP was significantly longer in transplanted patients (hazard ratio, 0.50); at five years, 61.7 percent of transplanted patients were free from CPD. Over 10 years, the EDSS time trend was higher in patients treated with other DMT than AHSCT-treated patients (+0.157 versus −0.013 EDSS points per year). The likelihood of experiencing a sustained disability improvement was increased at three years after transplant for patients who underwent AHSCT compared with those treated with other DMTs (34.7 versus 4.6 percent).
“Our results are encouraging, because while current treatments for secondary progressive MS have modest or small benefits, our study found stem cell transplants may not only delay disability longer than many other MS medications, they may also provide a slight improvement in symptoms,” a coauthor said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.
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