Avonex for people who might get MS?

In April 1996, just months after Avonex (interferon beta-1a) was first approved for relapsing-remitting MS, a new clinical trial began. Biogen, the drug's manufacturer, wanted to determine whether Avonex could help people who have experienced a single isolated symptom suggesting future MS.

Those in the study had experienced just one attack of optic neuritis, unexplained vertigo, tremor, bladder incontinence, or bowel incontinence. They also had a number of lesions, or areas of damage, in the brain as seen on an MRI scan. Statistically, people with this history are at risk of developing definite MS over the next several years. Could Avonex treatment delay the occurrence of a second attack, and thus delay diagnosis of definite MS?

The trial, conducted by the CHAMPS study group, included 380 men and women between the ages of 18 and 50 at about 50 clinical centers in the U.S. and Canada. Some were given Avonex; others, an inert placebo. The trial was terminated early, because a "statistically significant" outcome was reached.

The data were published in the September 28, 2000, issue of the New England Journal of Medicine. Use of Avonex had indeed delayed, although it did not prevent, the onset of definite MS. MRI scans showed significant decreases in the development of new brain lesions, too. The study supports the advisability of obtaining an MRI scan when a first MS-like event takes place, to evaluate the individual's risk. If this "monosymptomatic disease" could be treated at a very early stage, future disability might be dramatically reduced. However, Dr. Stanley van den Noort, head of the Society's Medical Advisory Board, notes that at least some people with this history will never have a second attack.