Thanks for posting this. I don’t think the results look so good either and GWA I agree with you that nothing so far has proven effective for SPMS or PPMS.
I don’t know if this article will help in the interpretation of the results, but I saw it during the free access to the MS Journal (available through April) and thought it may help a little. The purpose of the study was to establish a baseline to help assess the risks/benefits of HDIT/ASCT in a clinical trial.
Survival and time to an advanced disease state or progression, of untreated patients with moderately severe multiple sclerosis in a multicenter observational database: relevance for design of a clinical trial for high dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation
Estimated probability of disease progression (increase in EDSS of 1 or more sustained for 180 days) in this sample (EDSS scores of 3.0-5.5 at baseline) was:
· 5% after one year
· 14% after two years
· 22% after three years
· 38% after five years
· 57% after 10 years, and
· More than 80% after 20 years of observation
So, my understanding of this (as one example) is that after 5 years, more than 60% of untreated people
with a baseline EDSS score of 3.0-5.5 would not be expected to experience an increase of 1 or more on the EDSS
. Or conversely, fewer than 40%
of people would be expected to experience an increase of more than 1 on their EDSS
over the course of 5 years or more.
Since more than 50% of the HDIT/ACST trial patients worsened on their EDSS over the course of 5+ years
–a question would seem to be not only were the results disappointing, but was HDIT/ACST possibly detrimental? Although the participants in these studies aren’t exactly comparable I think one has to at least ask the question.
At best, roughly comparing these two different studies, HDIT/ACST doesn’t seem to be any better than “placebo“, at least as far as I understand it.
Other comments or observations anyone?