High-efficacy disease-modifying therapies may reduce flare-ups in recently active secondary pro- gressive multiple sclerosis (SPMS), but they do not appear to offer any advantage over low-efficacy therapies for slowing disability progression, accord- ing to a study published in Neurology. Investigators compared the clinical effectiveness of high-efficacy treatments and low-efficacy treatments in 1,000 patients with recently active and inactive SPMS followed for 10 years. Patients with active SPMS treated with high-efficacy therapy experienced less frequent relapses than those on low-efficacy ther- apy (HR, 0.7; 95% CI, 0.5-0.9). However, the investigators found no evidence for a difference in relapse frequency between groups (HR, 0.8; 95% CI, 0.6-1.2) among patients with inactive SPMS. There was also no evidence found for a differ- ence in the risk for disability progression for both active and inactive SPMS (HRs [95% CIs], 1.1 [0.8-1.5], and 1.3 [0.9-1.8], respectively). “When the goal is to alleviate ongoing relapse activity, more potent therapy is justified,” a study coauthor said in a statement. “But when the goal is to limit disability progression in SPMS, both types of drugs show comparable effectiveness.”
