Untreated patients with MS are generally thought to have a lower risk of cancer than the general population. The authors aimed to assess the effects of disease modifying therapy on cancer risk in patients with MS.
There was no increased risk of cancer among patients treated exclusively with Immunomodulatory drugs (Interferon beta-1a, -1b, and glatiramer acetate) but those treated with immunospressant treatments (azathioprine, cyclophosphamide, mitoxantrone, mycophenolate mofetil, natalizumab, methotrexate, fingolimod, cladribine, and teriflunomide) showed an increased risk which was greater with duration of exposure (p<0.001).
The authors suggest knowledge of these results may influence the attitude of the medical profession with respect to the benefit to risk ratio when proposing DMT to MS patients.
Why are people researching this? I understand that people may be concerned that medications could cause cancer, and I suppose it is good to know that some medications do not correlate with an increase in cancer and others do, but couldn't these people spend their time researching a cure for MS? It just doesn't make a whole lot of sense to me.
Although, the above "update" didn't make me feel that research was being done in a useful way, the following information that my sister found and emailed to me, does give me some hope that, at least, some productive research is being conductive.
GeneTalk with 23andMe: Multiple Sclerosis
Multiple sclerosis (MS) is a chronic disorder of the central nervous system, which causes unpredictable and varying symptoms. MS usually strikes between the ages of 20 and 50 and is more common in women than men. Recently, a number of research groups have found genetic variations associated with increased risk for MS.
23andMe corresponded with Dr. Lawrence Steinman about the complex interplay between genes and environment—and how this affects a person’s risk of developing multiple sclerosis (MS). Dr. Steinman is Professor of Neurology and Neurological Sciences, and Chair of the Stanford University Program in Immunology. His laboratory utilizes novel technologies to study the pathogenesis of autoimmune diseases, particularly MS. Dr. Steinman is a clinician at the Stanford University Medical Center, where he treats patients with MS and other autoimmune diseases.
23andMe: How does a person’s genetic makeup affect their risk of developing MS?
Dr. Steinman: There are now three genes that show an association with susceptibility to MS. The magnitude of these associations is not especially high for any given individual. Even if you had an identical twin with MS, the probability that you too would have the disease is only about one in four. If your twin is fraternal rather than identical the risk that you would have the disease drops to somewhere between 1 in 20 and 1 in 50. Therefore, there are stronger influences other than the versions of genes that you inherit governing whether you develop MS.
23andMe: Historically, how have doctors used genetics when predicting a patient’s risk of developing MS?
Dr. Steinman: At present doctors do not use genetics for predicting a patient’s risk of MS. The riskier versions of the three genes now associated with the risk of MS do not confer a very large increase in risk. The risky version of HLA-DRB1 confers a relative risk of only three- to four-fold, so it is not overly helpful for estimating a risk that on average is approximately one per one thousand in the United States.
The higher-risk versions of the other genes associated with MS, IL7RA and IL2RA, carry a much lower relative risk than HLA-DRB1*1501. [Note: 23andMe does not report genotype at IL2R.] These two genes explain only about 0.2% of the risk for MS. The higher-risk versions of IL-2R and IL-7R are found in about 70 percent of those without MS in the population.
23andMe: Recent genome-wide association studies have enabled scientists to identify genetic markers associated with increased risk of MS. How do you think this information can be put into clinical practice?
Dr. Steinman: Right now, this information is more useful as a research tool to identify clues to the pathological mechanisms involved in the disease. Other analyses look at what genes are actually switched on in the MS lesions in brain tissue from MS patients; these studies are revealing some remarkable clues on how the disease attacks the white matter of the brain.
For instance, we recently reported that the gene encoding the major protein in the lens of the eye is switched on in brain tissue from MS patients. While this may be the brain’s response to the damage caused in MS, the immune system also attacks the newly produced protein, preventing it from exerting its full protective activities.
23andMe: If I had a collection of the riskier versions of the SNPs known to be associated with MS, what would you suggest that I tell my personal physician?
Dr. Steinman: There would be no need to worry about the riskier versions of these SNPs. These SNPs are found in a high percentage of normal individuals in the population.
The reason that this is good, in my opinion, is that research is going toward possible genetic links to MS.
My sister forwarded me some other information that I have, unfortunately, not had a chance to read yet. I will report to you all when I have read the other information she sent. Also, yesterday I received my first "Momentum" magazine from the National MS Society and I am excited to read through that and report what I learn.
Had a good day today, but I am still very busy at work. I will try to post again very soon. Hope all is well!