Gene Activity Defines Two Types of MS - Multiple Sclerosis (MS) Information, and resources

This report is part of a 12-month Clinical Context series.

By John Gever, Senior Editor, MedPage Today

Published: September 27, 2012

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Gene transcription patterns separate multiple sclerosis (MS) patients into two groups, one of which appears more responsive than the other to standard therapies, researchers said.

In a study of 315 patients with relapsing-remitting MS and 48 with clinically isolated syndrome (a single demyelinating event), those with a transcription profile denoted as type B who were treated with glatiramer acetate (Copaxone) or interferon-beta drugs were significantly less likely to develop a major disease event than those with a type A profile, reported Philip De Jager, MD, PhD, of Brigham and Women’s Hospital in Boston, and colleagues.

The hazard ratio for a disease event — a demyelination event, new T2 hyperintense or gadolinium-enhancing lesion on MRI scans, or sustained 6-month disability progression — was 0.6 for type B versus type A (95% CI 0.41 to 0.87, P=0.0077), the researchers reported online in Science Translational Medicine.

“This hazard ratio suggests that [patients with type B] MS are 40% less likely to have a relapse than [type A] MS,” De Jager and colleagues wrote. “Stratifying MS subjects into meaningful subsets in this manner has potential for personalizing patient care and for enhancing our understanding of this disease.”

They acknowledged, however, that their study had important limitations — they did not evaluate responsiveness to other MS drugs such as fingolimod (Gilenya) or natalizumab (Tysabri), nor did they include patients with primary or secondary progressive MS.

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