High Intensity Treatment for Multiple Sclerosis
An article in the current issue of John Hopkins Magazine describes a clinical trial in which high doses of cyclophosphamide were used to relieve symptoms associated with multiple sclerosis(MS). The treatment is also referred to as "HiCy." Treatment with low doses over a long term had been used since the 1980s but the treatment came with some pretty serious side effects. The inflammation of MS was reduced but patients became susceptible to infection and tumors.
Doug Kerr, a neurologist at Johns Hopkins, and colleagues Richard Jones and Robert Brodsky had used high doses given over a few days to patients with immune diseases such as lupus and aplastic anemia. The treatment had reversed disease progression with minimal toxicity. The idea behind the high-dose treatment for MS was to knock out the infection completely and hope that the immune system would rebound and behave better.
Their idea seems to have worked. Of the first nine patients they treated this way, seven had reduction in disability after two years. Twenty-nine patients, including Chris Young, have been enrolled in a second trial with similar results and no adverse effects.
In 2004 Chris Young woke up barely able to move his body on the right side. He was 29 when he was diagnosed with MS and his disease got worse over the next few years. It was October of 2007 when he found out about the Hopkins clinical trial, called and was accepted for the study.
His short term memory was awful. Lists didn't really help because he would forget where he put the lists. Five days after the treatment he woke up and everything was clear. Within a week of treatment he could stand in the bathtub without holding on and three months later he was walking without a cane.
"In most therapies for MS, the goal is only to make the disease slow down a little bit. Here, people actually got better," says hematologist and oncologist Douglas Gladstone of Hematology Oncology Associates of Western Suffolk, in New York. Additional research by Gladstone, who served a fellowship at Hopkins in the late 1990s, has also shown the effectiveness of HiCy on 14 MS patients. "This potentially represents a new standard of care," he adds.
Kerr said that the next step is to have a blinded clinical trial at multiple centers. While he is encouraged by the results, he emphasizes the need for further study. His team is also working on combination drug therapies to be used for those whose MS did not go quiet with the HiCy therapy.
