Using magnetic resonance imaging, researchers showed that new brain lesions that indicate multiple sclerosis (MS) progression were reduced by more than half in 12 of 14 patients treated with the drug Imuran. The drug is now used primarily to prevent rejection in transplant patients and in the treatment of patients with rheumatoid arthritis and other autoimmune disorders. Imuran has been studied by MS investigators for several decades. Previous studies have shown that Imuran can reduce relapses in patients with multiple sclerosis. However, the new research is the first to show that the drug can slow disease progression by decreasing the presence of new lesions.
Study researchers say their findings are similar to other studies' results looking at the use of injectable interferon-beta and brain lesions in MS. But a spokesman for the National MS Society tells WebMD that larger studies are needed to prove this.
'If these findings are confirmed then we would have a less expensive oral medication that is of comparable benefit to the current treatments,' says John Richert, MD. 'These data show that it is worthwhile to invest the resources to try and prove that this drug alters disease progression.'
Link to WebMD article (the study will be pubished in the Archives of Neurology in December).
Update: Link to abstract for Imuran study
[Cost-utility analysis of relapsing-remitting multiple sclerosis treatment with azathioprine or interferon beta in Spain]
[Article in Spanish]
Rubio-Terres C, Dominguez-Gil Hurle A.
HERO Consulting, Health Economics and Research of Outcomes, Virgen de Aranzazu 21, E-28034 Madrid, Spain. firstname.lastname@example.org
AIM: To carry out a cost-utility analysis of the treatment of relapsing-remitting multiple sclerosis (RRMS) with azathioprine (Imurel) or beta interferon (all, Avonex, Rebif and Betaferon). MATERIAL AND METHODS: Pharmacoeconomic Markov model comparing treatment options by simulating the life of a hypothetical cohort of women aged 30, from the societal perspective. The transition probabilities, utilities, resource utilisation and costs (direct and indirect) were obtained from Spanish sources and from bibliography. Univariant sensitivity analyses of the base case were performed. RESULTS: In the base case analysis, the average cost per patient (euros in 2003) of a life treatment, considering a life expectancy of 53 years, would be 620,205, 1,047,836, 1,006,014, 1,161,638 and 968,157 euros with Imurel, all interferons, Avonex, Rebif and Betaferon, respectively. Therefore, the saving with Imurel would range between 327,000 and 520,000 euros approximately. The quality-adjusted life years (QALY) obtained with Imurel or interferons would be 10.08 and 9.30, respectively, with an average gain of 0.78 QALY per patient treated with Imurel. The sensitivity analyses confirmed the robustness of the base case. The cost of one additional QALY with interferons would range between 413,000 and 1,308,000 euros approximately in the hypothetical worst scenario for Imurel. CONCLUSIONS: For a typical patient with RRMS, treatment with Imurel would be more efficient than interferons and would dominate (would be more efficacious with lower costs) beta interferon.
Link to abstract.