SALT LAKE CITY — The risk of permanent disability from a multiple sclerosis attack is extremely rare and does not appear to be tied to drug holidays, data on more than 1,000 MS patients showed.
A catastrophic attack of multiple sclerosis is feared by patients and physicians alike, sometimes influencing treatment decisions, said Dr. Loren A. Rolak, a neurologist at the Marshfield (Wis.) Clinic in an interview. “The debate still simmers a bit in MS circles about how disabling attacks are in general, as opposed to the progressive, neurodegenerative atrophic process of MS, where people sort of slowly get worse,” he said.
Dr. Rolak and his associates analyzed data from 1,078 MS patients who had a total of 2,587 attacks over a 34-year period. They reported their findings in a poster at the annual meeting of the American Neurological Association.
Seven patients had a disabling attack, defined as a relapse that resulted in a permanent Expanded Disability Status Scale score of 6 or greater. That level of impairment is associated with the loss of unaided mobility.
“It was extremely rare … 1 in 369 attacks,” Dr. Rolak said. In two of the seven cases, the disabling attack was the result of de novo tumefactive MS; another two patients were on interferon therapy.
Physicians who want to wait before prescribing medication to a newly diagnosed MS patient, or to approve a drug holiday in a woman who wants to become pregnant, may find reassurance in the study, Dr. Rolak suggested.
Dr. Rolak's study was not funded by a pharmaceutical company.