Multiple Sclerosis Stem Cell Transplant Compared to Disease-Modifying Therapy

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Multiple Sclerosis Stem Cell Transplant Compared to Disease-Modifying Therapy

In a rare clinical trial, stem cell transplantation appeared to provide greater protection against MS progression than DMT.

Stem cell transplantation appeared to provide greater protection than disease-modifying therapy (DMT) against progression of relapsing-remitting multiple sclerosis (MS), in the first randomized clinical trial to compare the interventions.

Richard Burt, MD, Division of Immunotherapy, Northwestern University Feinberg School of Medicine, Chicago, IL, and colleagues described the unmet need in MS treatment, and the potential for stem cell transplantation as a treatment option.

“Despite a 2013 annual cost of treatment with DMT of approximately $65,000 per patient, the proportion of patients with no evidence of disease activity is 30% to 50% after 2 years of treatment, and approximately 18% after 4 years of treatment,” Burt and colleagues observed.

“The majority of patients with relapsing-remitting MS eventually enter an axonal degenerative phase of irreversible and progressive disability for which there are no significant efficacious therapies and during which there is an increase in disease-related mortality,” they indicate.

In contrast with DMT, the investigators explained, hematopoietic stem cell transplantation (HSCT) is designed to eliminate autoreactive lymphocytes, and essentially restart a new immune system in a non-inflammatory environment without costimulatory signals.

Burt and colleagues conducted the Multiple Sclerosis International Stem Cell Transplant (MIST) randomized clinical trial to compare the effects of nonmyeloablative HSCT treatment with continuing DMT treatment on disease progression among patients with highly active relapsing-remitting MS.

Read on: Multiple Sclerosis Stem Cell Transplant Compared to Disease-Modifying Therapy

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