home *** CD-ROM | disk | FTP | other *** search
- <text id=93TT1322>
- <title>
- Mar. 29, 1993: Fighting a Crippler
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1993
- Mar. 29, 1993 Yeltsin's Last Stand
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- MEDICINE, Page 51
- Fighting a Crippler
- </hdr>
- <body>
- <p>A new drug appears to be the first to slow the progress of multiple
- sclerosis
- </p>
- <p>By J. MADELEINE NASH CHICAGO--With reporting by Dick Thompson/
- Washington
- </p>
- <p> Imagine what it must be like to stroll down a street and
- then suddenly lurch like a drunkard. To see double images of a
- coffee cup, a friend's face, a newspaper. To feel dizzy because
- rooms seem to spin like merry-go-rounds. The onset of such
- symptoms 10 years ago sent Chicago sales representative Suzanne
- Arens, now 39, stumbling to a neurologist. The diagnosis:
- multiple sclerosis. "It was devastating," she recalls. "The
- disease progressed to where I would have an attack every six
- months. I was hospitalized three times." For the past five
- years, however, Arens has managed to remain symptom-free, the
- result, she is convinced, of regular treatments with a
- promising, if still experimental drug, beta interferon. "I used
- to see a wheelchair at the end of the tunnel," says Arens. "Now
- I see a life."
- </p>
- <p> In reality, Arens doesn't know for sure whether the
- injections she has been giving herself every other day contain
- beta interferon. As one of 372 participants in a clinical trial
- overseen by 11 medical centers in the U.S. and Canada, Arens
- realizes she may have been randomly assigned to a control group
- and given a harmless placebo, in this case saline solution. But
- some telltale side effects--chills and inflammation at the
- injection site--suggest, to Arens at least, that she has been
- receiving the genuine article.
- </p>
- <p> Last week a Food and Drug Administration panel reviewed
- soon-to-be-published results from the clinical trial in which
- Arens has been participating. The study showed that patients
- receiving a recombinant form of beta interferon did better than
- those getting the placebo. The difference was quite dramatic for
- those patients who received high dosages of the drug, which is
- manufactured by Chiron Corp. and Berlex Laboratories. Compared
- with the control group, high-dose patients suffered 50% fewer
- serious attacks of the disease, and those attacks were of
- shorter duration. Moreover, brain scans revealed that this group
- of patients incurred fewer central nervous system lesions,
- suggesting that the therapy may be more than purely palliative.
- It may in fact be the first effective weapon to slow the
- progress of the disease, which afflicts as many as 350,000
- Americans.
- </p>
- <p> The panel was sufficiently impressed to recommend--by a
- vote of 7 to 2--that the FDA approve the drug for the 30% of
- MS patients who, like Arens, have a mild or moderate form of
- the disease, characterized by months of quiescence interrupted
- by terrifying relapses.
- </p>
- <p> Multiple sclerosis is considered an autoimmune disease,
- caused by the biological equivalent of friendly fire. For
- reasons that remain vague, cells of the immune system turn their
- potent chemical weapons against the myelin sheath that protects
- nerve fibers in the spinal cord and brain. While the severity
- of the disease varies widely, the resulting nerve damage can
- cause progressive disablement that, after two decades, leaves
- 30% of patients in wheelchairs.
- </p>
- <p> The path that led medical researchers to beta interferon
- was hardly straightforward. Initially, some scientists believed
- attacks characteristic of multiple sclerosis might be triggered
- by chronic viral infections. So in 1984 they began testing
- gamma interferon, one of the body's own antiviral weapons, in
- MS patients. To their horror, patients became dramatically
- worse. The false step proved instructive however. "It told us
- that gamma interferon was a major player in this disease,"
- explains neurologist Dr. Kenneth Johnson of the University of
- Maryland at Baltimore.
- </p>
- <p> Researchers later learned that the level of gamma
- interferon present in the cerebrospinal fluid of MS patients
- skyrocketed just before and during acute attacks. Attention
- therefore shifted to a cousin molecule, beta interferon, which
- appears to play the role of inhibiting gamma. At the University
- of Chicago, Dr. Avertano Noronha and his colleagues demonstrated
- that beta interferon markedly decreased the activity of white
- blood cells obtained from multiple sclerosis patients. Beta
- interferon, they found, not only restrained the proliferation
- of these cells, it also shut down their production of
- myelin-destroying compounds.
- </p>
- <p> No one, it should be stressed, believes beta interferon is
- a cure for multiple sclerosis. Some patients receiving the drug
- have continued to deteriorate, while others who appear to have
- benefited probably would have improved anyway (the disease is
- often punctuated by remissions). Moreover, the utility of beta
- interferon for steadily progressive forms of multiple sclerosis--an unfortunate minority of cases--has yet to be shown.
- </p>
- <p> Still, the appearance of any compound that can positively
- alter the course of this relentless disease is cause for
- cautious celebration. "Half a loaf," observes University of
- Chicago neurologist Dr. Barry Arnason, whose research helped
- stimulate interest in beta interferon, "is a lot better than no
- bread." If the FDA goes along with the panel's recommendation
- and approves the drug, says Stephen Reingold, chief of research
- for the National Multiple Sclerosis Society, "I predict it will
- be used widely--and it should be."
- </p>
-
- </body>
- </article>
- </text>
-
-