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Drugs for multiple sclerosis

Clinical bottom line

There is a depressing lack of evidecne for any efficacy from the clinical trials. There is some adverse effect cost to these treatments, and some have great cost.


A Clegg et al. Disease-modifying driugs for multiple sclerosis: a rapid and systematic review. Health Technology Assessment 2000 4: No 9. (available as a PDF from HTA)

This is a 113-page review of drugs for the treating MS. It set out to provide a rapid review of treatments and the efficacy of disease-modifying drugs. A complete review here is both impossible and unnecessary, as a PDF of the whole report is available from the HTA Internet site. The main results were, briefly:


There is some evidence that azathioprine may reduce relapse rates, but with many common adverse effects, including gastrointestinal disorders. Cost per patient is £50 to £1200 a year.

Beta interferon

Limited benefit in relapsing-remitting and secondary progressive MS. Flu-like symptoms common, and injection site reactions. Cost per patient is £10,000 to £20,000 a year.


Two small trials unlikely to show anything useful. Cost £6,000 to £9,000 a year


Five randomised trials, predominantly small. Lots of adverse effects, and limiteed evidence of efficacy. Cost £100 a year.


Very limited evidnece of efficacy. Annual cost £10,000.

Intravenous immunoglobulin

More evidnece for this, with some reduced relapse rates. Cost is £2,000 to £10,000 a year. A more detailed review can be found here. The HTA review was less depressed about IVIG than the Bandolier review.


No real evidence of efficacy for this cheap drug. Cost is <£100 a year.