By Richard Robins
LONDON, ENGLAND -- June 22, 2001
-- Contrary to the results of a previous study, anti-herpes virus treatment
provides no benefit in relapsing-remitting multiple sclerosis (MS), according
to a study presented at the 17th World Congress of Neurology in London,
June 17-22 2001.
"Viruses have been looked for as
the agent possibly involved in the pathogenesis of MS," said lead author
Jan Lycke of the Department of Neurology of Sahlgren's University Hospital,
Goteborg, Sweden. "However, no specific agent has repeatedly and convincingly
been identified." A previous double-blind trial with aciclovir in MS showed
a 34 percent reduction in active lesions, although the probability value
fell just short of significance.
Dr. Lycke and colleagues decided
to test the prodrug of aciclovir, called valaciclovir, an agent with even
broader action against the herpes viruses, the most commonly suspected
candidates in MS pathogenesis. They enrolled 70 patients with relapsing-remitting
MS, and randomized them to receive either placebo or 3 grams valaciclovir
per day for 24 weeks. Patients underwent MRI imaging of active lesions
every four weeks throughout the study.
At the end of the study, the mean
total of new lesions per patient was 11.9 for the valaciclovir group, and
14.5 for the placebo group, an insignificant difference (p=0.71). Similarly,
the number of new lesions per scan per patient was also not significantly
different, with 1.9 for valaciclovir, versus 2.6 for placebo (p=0.44).
Because the inter-patient variation was high though, Dr. Lycke retrospectively
stratified patients into those with high and low baseline MRI activity.
When grouped this way, the high-activity patients did seem to benefit from
treatment, with significantly fewer lesions than placebo treated patients
(p=0.025).
"Our results do not support a major
role for aciclovir-susceptible viruses in relapsing-remitting multiple
sclerosis," Dr. Lycke concluded, but he did suggest that further study
of this treatment in high-MRI activity patients may be warranted.
Special to DG News