Guidelines for early treatment trials in patients presenting with clinical and paraclinical abnormalities which put them at high risk for conversion to multiple sclerosis

Abstract

Several recent dinical trials have shown that interferon beta, a rather well-tolerated therapy, can favourably alter the pathological disease activity in MS, decrease the frequency of relapses and slow down the progression of the disability. Clinical and biological observations suggest that immune abnormalities in MS can be corrected more easily during the first stages of the disease, and thus early treatments may be more effective. In addition, the results of the Optic Neuritis Treatment Trial suggest that administration of a therapy immediately after the first attack may delay the occurrence of subsequent signs and/or symptoms and, by the same token, the conversion to clinically definite MS. Moreover, we know that the dinical activity of the disease during the early stage is strongly predictive of the subsequent evolution. For all these reasons, it seems thus justified to evaluate whether treatment with effective and well-tolerated drugs can retard the long-term disability and improve the quality of life of patients who present with clinical signs and paraclinical tests which put them at high risk of developing MS.