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Multiple-Sclerosis Study Could Help Patients

Research Shows Possibility of Identifying Who Will Benefit From Beta-Interferon

Research from Stanford University suggests it may become possible to identify which multiple-sclerosis patients will respond to the leading MS medicine and which won't.

Differentiating between responders and nonresponders to beta-interferon could help thousands of people skip the drug and avoid the flu-like symptoms that accompany it, while assuring others that they are likely to benefit, doctors said.

The researchers, led by Lawrence Steinman and Robert C. Axtell of Stanford's neurology department, concluded that a simple blood test could indicate which patients were most likely to benefit from beta-interferon, which minimizes the relapses suffered by some MS patients.

The research, published online Sunday in Nature Medicine, could have repercussions in the $4 billion beta-interferon industry. Manufacturers of various forms of beta-interferon include Biogen Idec Inc., BIIB -0.89 % Bayer AG BAYN 0.40 % , Novartis AG NVS -0.67 % and Merck Serono SA. Alfred Sandrock, Biogen Idec's senior vice president for neurology research, described the work as "interesting but preliminary" and said it "could be a very useful advance for MS patients." He said his company planned to collaborate with Dr. Steinman on related research.

Multiple sclerosis is generally believed to be an autoimmune disease in which the patient's own cells attack the insulation, called myelin sheath, that surrounds nerves. Some 400,000 people in the U.S. and 2.5 million people world-wide have MS.

Most MS patients are of the "relapsing-remitting" type, where the disease flares up periodically and largely disappears for long periods of time. Beta-interferon, an injectable medicine that costs about $25,000 and up annually, lowers the relapse rate by roughly one-third in the half of patients who respond.

The drug also causes flu-like symptoms like aches, fever and muscle pain that can last for hours. The side effects often discourage patients from taking the medicine as prescribed, especially since it can take two years or more before it becomes apparent if it is helping.

That is where the current research could help. Dr. Steinman said the drug is generally thought to have a "somewhat modest effect" on easing relapses because it only helps some of the people who take it. But this perception of the drug could change, he said, "if we knew in whom it would work and in whom it didn't work at all." Among the MS patients who do respond to beta-interferon, the effectiveness of the drug may potentially be greater than now believed.

The researchers found two distinct chemical pathways through which the body's inflammatory immune-system response triggers MS. One pathway corresponded to people who responded to beta-interferon, the other to people who didn't.

The research was conducted first in mice, then verified in analysis of blood samples of 26 patients. Stanford has filed a patent application for a blood test that would distinguish between responders and nonresponders, but said the researchers wouldn't benefit financially.

Dr. Sandrock estimated it could be a year or two before a blood test might be submitted to the Food and Drug Administration for possible U.S. marketing approval.

Write to Thomas M. Burton at

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