I found this article on the Barts MS Blog by the professor there and thought you folk may find it interesting
“You may recall the post I did on a study of interferon-beta treatment in PPMS. After 2-years of treatment there was no difference between PPMSers who had been treated with IFNbeta or placebo. The investigators’ concluded that interferon-beta was ineffective in PPMS. However, when these patients were reassessed at 5-years there were clear clinical and MRI features favouring interferon treatment. I suggested that in progressive MS there was a lag in the onset of action of interferon-beta. I proposed that the impact of anti-inflammatory medications in progressive MS may take several years to play out. In other words progression over the next 2 years is primed by inflammation occurring in the past. Therefore, suppressing inflammation today will have not have an impact over the next 2-years as the damage that has primed progression over the next 2 years has already occurred. In other words all anti-inflammatory therapies will have a lag in terms of showing a treatment response in progressive MS.”
Have any of you been told my your neuro what exactly is happening in PPMS. We know in RRMS the immune system attacks the myelin causing inflammation an d sometimes this leads to axonal damage. In PPMS DMDs dont work so is the immune system not involved in the same way ? Also is there no inflammation which is why steriods dont work ?