Clinical drug trials show promise in halting progressive brain atrophy of MS patients

Dr. Vijayshree Yadav, associate professor of neurology at OHSU, left, with MS patient and clinical drug trial subject, David Smeltzer. (KATU)

Patients with multiple sclerosis, the progressive disease that can lead to paralysis, cognitive impairment and vision loss, can also lead to a shrinking, or atrophy of the brain.

Phase two of clinical drug trials of a new medicine, however, has shown up to a nearly 50 percent slowing of that atrophy.

OHSU doctors and patients participated in the study.


In what could be the first real effective treatment for primary and secondary multiple sclerosis, a study published in the New England Journal of Medicine showed that the drug ibudilast (i-bood ah last) slowed the progressive shrinkage of MS patient's brains.

“Atrophy is just the loss of the neural tissue,” said Dr. Vijayshree Yadav, associate professor of neurology at OHSU. “It’s a lifelong disease so as the disease progresses with age, you will have shrinkage of the brain and the spinal cord.”

The brains of 255 patients, including 12 at OHSU, at 28 hospitals across the United States were studied using advanced MRI imaging over a two-year period.

“They had significant preservation of the brain volume over the two-year period and this was close to 50 percent compared to the placebo group,” Yadav said. “The placebo group continued to decline.”

One of those dozen OHSU patients in the study was 37-year-old David Smeltzer.

Smeltzer was diagnosed with MS in 2005, in his early 20s.

He has primary MS and gets around these days in a motorized wheelchair.

He jumped at the chance to participate in the study and received the real drug during the study.

“There was no hesitation at all,” Smeltzer said. “It was just a matter of give me the papers and I’ll sign ‘em, and let’s get started.

“If I can do anything to add to this knowledge pool while selfishly thinking, I want to get onto a treatment that would help.”

Smeltzer, who realized his dream of being a radio announcer after his diagnosis, says while there's always hope, he has dealt with the disease with acceptance -- and a sense of humor.

"I always have this attitude that if I can’t’ laugh at things, then I give up,” he said. “And by the way, my brain is not shrinking, despite what you may have heard.”

MS affects 2.3 million people worldwide due to the damage to nerve fibers in the brain and spinal cord.

Doctors say more research is needed to see if the drug can slow the progression of thinking, walking and other symptoms associated with MS.

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