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ANNOUNCER: Multiple sclerosis affects an estimated 300,000 Americans. While once there were no effective treatments, today there are a variety of therapies that can slow not only the progression of the disease but increase disease-free intervals. One such treatment uses interferons.
DUSAN STEFOSKI, MD: Interferons are chemicals, specifically proteins that our bodies make, which have an ability to change many functions within a human system. And among those are some effects on the immune system where they can bring it closer to normal.
ANNOUNCER: Since MS is thought to be a disease of the immune system, interferons have been shown to be a successful treatment for many. The key to their success is using them regularly.
PATRICK PARCELLS, MD: Unfortunately, when I see a patient with MS, I tell them, "You have a disease that's going to be there the rest of your life. So long-term treatment is important so we can have the greatest impact of the disease that we can."
DUSAN STEFOSKI, MD: It is the relative ease of human systems to tolerate long-term treatment with interferons that make them so attractive. They're not cures so one can expect a person to remain on interferon therapy, if it is seemingly efficacious or beneficial, for not necessarily a lifetime, but at least until a better drug or a cure has been found.
ANNOUNCER: However some people produce substances in their bodies that may fight off the interferon that's trying to help them.
DUSAN STEFOSKI, MD: As a foreign protein entering the human body, the immune system launches in some people a defense and those antibodies which are known as neutralizing antibodies will render interferons inefficacious.
PATRICK PARCELLS, MD: If you develop neutralizing antibodies and you're on one of the interferon drugs, you're blocking the effect of the interferon, therefore increasing the likelihood of having a relapse or progression of disease.
ANNOUNCER: Neutralizing antibodies take a while to develop and their appearance can be worrisome.
PATRICK PARCELLS: We know that the interferons diminish the risk of relapses by about a third, and therefore, if you prevent that effect you have a third greater chance of having a relapse if you've developed neutralizing antibodies.
ANNOUNCER: Currently there are several different forms of interferon therapy.
DUSAN STEFOSKI, MD: What is important to know is that not all interferons generate the same amount of neutralizing antibodies. Some do more than others. If you stack them up, Avonex has the fewest; 5% or less people will have neutralizing antibodies. The second one is Rebif, anywhere between 15 and 25%. And Betaseron has the highest, about 30 to 40% of all patients will develop neutralizing antibodies.
ANNOUNCER: Many people with MS will have relapses, even on interferon. However, it's important to discover whether the relapse is part of the disease process or a result of neutralizing antibodies.
PATRICK PARCELLS, MD: If a patient is on a treatment and has a breakthrough, a relapse, or if they're getting worse progression of disease, the first thought in their mind, number one, is: is the patient compliant? Are they taking the treatment? If they are, the second thought should be, have they developed neutralizing antibodies? If you develop neutralizing antibodies, you don't feel them. There's no way a physician can examine a patient and tell. However, the way to determine it is to measure them in the blood.
DUSAN STEFOSKI, MD: If and when they do develop, then a person needs to stop interferon because it's no longer working and probably go on another medication.
PATRICK PARCELLS, MD: If you think about the neutralizing antibody problem, when choosing an interferon therapy, that aspect of it plays a large role in my decision to use one interferon over another, because patients, even on treatment, may still have relapses, and I want to be sure that the problem, if they do have relapses, is not the fact that their interferon is not working because they develop antibodies.
ANNOUNCER: Not everybody developes neutralizing antibodies so for many patients with ms, interferon therapy can be a long term effective way to deal with a chronic disease.
PATRICK PARCELLS, MD: These drugs are really preventive drugs, and so it's our job as neurologists to try to tell patients, "You really need to be on treatment." We have treatments that are effective; that work and can certainly have an impact on their life and their quality of life, and that clearly, the sooner they go on treatment, the better they're going to be down the road.
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