Researchers Publish Comparison of MS Treatments

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Researchers at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School (UMDNJ-NJMS) have found that one FDA-approved multiple sclerosis medication, Betaseron (interferon beta-1b), is more effective than another medication, Copaxone (glatiramer acetate), in limiting the formation of so-called “chronic black holes” in the brain that are believed to represent irreversible damage in multiple sclerosis. Their findings have been published online by the Journal of Neurology, Neurosurgery & Psychiatry.

This study is the latest analysis of data to emerge from the ongoing BECOME trial (Betaseron vs Copaxone in MS with Triple-Dose Gadolinium and 3-T MRI Endpoints), conducted by UMDNJ, which for two years closely followed 75 patients in northern New Jersey with either relapsing-remitting MS or a clinically isolated syndrome (CIS), often the initial clinical manifestation of MS.

“This is the first and largest head-to-head trial by sensitive monthly MRI technology comparing two leading medications, and it has produced a wealth of information about the natural history of multiple sclerosis during treatment with first line MS therapies,” said Stuart D. Cook, M.D., a professor of neurology and neurosciences at New Jersey Medical School and an author of the study. 

“Important findings to date include longer duration of enhancing lesions than earlier thought, the higher rate of enhancing lesions before T2 lesions occur, and the ratio of asymptomatic new MRI lesions to clinical symptoms (30 to 1).”

An earlier paper emerging from the BECOME trial, published in June in the journal Neurology (Neurology.2009; 72: 1976-1983), showed similar outcomes for the two tested medications, where the criteria were the appearance of new active or enhancing MS lesions in the brain and of new clinical exacerbations in patients.

This latest study, however, indicates a divergence between the two medications with regard to the evolution of chronic black holes from newly enhancing lesions. Among newly enhancing MS lesions in patients receiving Betaseron, 9.8% converted to chronic black holes (black holes with duration beyond a year), while 15.2% of new lesions in patients receiving Copaxone converted (P=0.02). In addition, the rate of conversion from acute black holes to chronic black holes was lower in patients receiving Betaseron (15.2%) than in patients receiving Copaxone (21.4%), though that difference was only of borderline statistical significance (P=0.06).

To the extent that chronic black holes are linked in the future to long term progression and disability in MS, Dr. Cook says these findings, if confirmed, could influence treatment of patients with the disease.

About the BECOME Study
The BECOME (BEtaseron vs. COpaxone in MS with triple-dose gadolinium and 3-T MRI Endpoints) study is the first head-to-head, prospective, randomized clinical trial that compared the efficacy by MRI parameters of glatiramer acetate and interferon beta-1b for treatment of relapsing-remitting MS or clinically isolated syndromes suggestive of MS. Seventy-five patients were randomized to receive subcutaneous interferon beta-1b (250 micrograms every other day) or glatiramer acetate (20 mg daily) beginning at the baseline visit. The study used serial 3T brain MRI scans, which enabled the investigators to examine the evolution of chronic black holes over time.

The study was investigator-initiated, and sponsored by Bayer HealthCare, the distributor of interferon beta-1b.

About New Jersey Medical School
Founded in 1954 as the Seton Hall College of Medicine and Dentistry, UMDNJ-New Jersey Medical School was the state’s first medical school. Today, it is part of the University of Medicine and Dentistry of New Jersey. NJMS has four mission areas: education, research, clinical care, and community outreach. It has 21 departments and more than 70 centers and institutes. In addition to offering the MD degree to its students, NJMS also offers, MD/PhD, MD/MPH, and MD/MBA degrees through collaborations with other institutions of higher education.

About the University of Medicine and Dentistry of New Jersey
The University of Medicine and Dentistry of New Jersey (UMDNJ) is the nation’s largest free-standing public health sciences university with more than 5,700 students attending the state’s three medical schools, its only dental school, a graduate school of biomedical sciences, a school of health related professions, a school of nursing and a school of public health on five campuses. Annually, there are more than two million patient visits at UMDNJ facilities and faculty practices at campuses in Newark, New Brunswick/Piscataway, Scotch Plains, Camden and Stratford. UMDNJ operates

Source:  University of Medicine and Dentistry of New Jersey (UMDNJ)

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