Oral MS drugs offer new horizon

Two new oral drugs shown this week to lower relapse rates in patients with multiple sclerosis provide a ‘new horizon’ for patients and a welcome increase in the range of treatment options, says William Carroll, a neurologist from Sir Charles Gairdner Hospital, Perth. Oral drugs for MS would not only improve patient acceptance of treatment, but also "further support a change in treatment approach to directly prevent immune-mediated injury," Carroll wrote in an editorial accompanying three phase III studies published in the NEJM. The manufacturer-conducted, double-blind trials, involved fingolimod and cladribine. While the drugs differ in their mechanism of action, both reduce the number of potentially autoaggressive lymphocytes that are available to enter the central nervous system. Using annualised rate of relapse as the primary end point, high and low doses of cladribine and fingolimod were superior to both placebo and interferon beta-1a. For cladribine versus placebo (CLARITY), the relative risk reduction in the annualised relapse rate was 57.6% for the group receiving 3.5 mg per kilogram of body weight and 54.5% for those receiving 5.25 mg per kilogram....