Monday, 29 December 2014

Autoimmunity and MS

Marrie RA, Reider N, Cohen J, Stuve O, Sorensen PS, Cutter G, Reingold SC, Trojano M. A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis.
Mult Scler. 2014 Dec . pii: 1352458514564490. [Epub ahead of print]

BACKGROUND:As new therapies emerge which increase the risk of autoimmune disease it is increasingly important to understand the incidence of autoimmune disease in multiple sclerosis (MS).
OBJECTIVE: The purpose of this review is to estimate the incidence and prevalence of comorbid autoimmune disease in MS.
METHODS:The PUBMED, EMBASE, SCOPUS and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles were searched, and abstracts were independently screened by two reviewers. The data were abstracted by one reviewer using a standardized data collection form, and the findings were verified by a second reviewer. We assessed quality of the included studies using a standardized approach and conducted meta-analyses of population-based studies.
RESULTS: Sixty-one articles met the inclusion criteria. We observed substantial heterogeneity with respect to the populations studied, methods of ascertaining comorbidity, and reporting of findings. Based solely on population-based studies, the most prevalent autoimmune comorbidities were psoriasis (7.74%) and thyroid disease (6.44%). Our findings also suggest an increased risk of inflammatory bowel disease, likely uveitis and possibly pemphigoid.
CONCLUSION: Fewer than half of the studies identified were of high quality. Population-based studies that report age, sex and ethnicity-specific estimates of incidence and prevalence are needed in jurisdictions worldwide.

One of the major side effects of Lemtrada isthe development of secondary B cell mediated autoimmunities and this occurs in about 20-50%  of people. This study looks to see if these occur independent of Lemtrada treatment and it can be seen in a low number of MSers. Psoriasis is not the main autoimmunity after Lemtrada but thyroid problems.

2 comments:

  1. So a quick search turns up a UK prevalence of psoriasis of about 1.5%, though there seems to be a big range worldwide.

    So is there a link between psoriasis and MS? The effect of dimethyl fumarate would suggest that there could be - any thoughts?

    I was recently diagnosed with MS and this makes me wonder about potential 'induction' therapies for MS. My mother had acute myeloid leukaemia 3 years ago and has had psoriasis since the age of 5yo. She received induction chemotherapy which consisted of cytarabine, daunorubicin and possibly etoposide (have had to search for these names again). Her psoriasis completely cleared up for a few months after the chemo and then came back as normal.

    These were really very heavy going drugs, but her immune disease returned as before. Do you think there're any conclusions that can be drawn about MS and the use of induction therapies? Will they really have a lasting effect?

    Have any of these pure chemotherapy drugs been tried in MS before?

    ReplyDelete
    Replies
    1. Both psoriasis and MS are thought to be autoimmune diseases therefore it is possible that drugs that will work on one will work on the other,

      The drugs you cite are anti-cancer drugs and may impact on MS but there is no evidence they work some have been tried at a time when neuros didn't know how to do trials that worked...however the side effect profiles may mean you would not want to use them in neurological conditions, because they are toxic to nerves..

      As to induction therapies they are not infallible and retreatment may be necessary. The only induction therapy available is lemtrada and about 50% of people need a retreatment to quell MS.The effects could wear off a few years later we will need to see what happens.

      Some of the drugs have a similar action to mitoxanrone which is approved for MS in some countries

      Delete

Please note that all comments are moderated and any personal or marketing-related submissions will not be shown.