Cognitive Skills Maintained in RRMS Patients Treated with Gilenya or Tysabri in Yearlong Study

Patricia Inacio, PhD avatar

by Patricia Inacio, PhD |

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cognitive function and MS

Disease-modifying therapies, a groupĀ of treatments for peopleĀ withĀ relapsing-remitting multiple sclerosis (RRMS), work to stabilize patients’ cognitive functionsĀ just as they do their physical symptoms. Research, conducted over the course of a year, also reportedĀ no differences between two types of DMTs,Ā Gilenya (fingolimod) andĀ Tysabri (natalizumab).

The study, ā€œCognitive functions over the course of 1 year in multiple sclerosis patients treated with disease modifying therapies,ā€ was published in the journal Therapeutic Advances in Neurological Disorders.

The ultimate goal of disease-modifying therapies, or DMTs,Ā is to delay or prevent disease progression. In MS, increasing physical disability andĀ cognitive impairment are the two disease features seen toĀ worsen over time. While the beneficial effects of DMTs areĀ largelyĀ establishedĀ for physical symptoms, the therapies’ long-term effectsĀ on cognitive function are still contradictory. Particularly, the role of fingolimod, the first oral DMT, on cognitive functions remains unknown.

Researchers set out to assess cognitive functions in RRMS patients treated with DMTs for one year. To this end, theyĀ recruited 41 RRMS patients, whoseĀ cognitive functions were assessed with eight tests at three time points: baseline, six-month follow-up, and 12-month follow-up.

Results for the patients were compared to those obtained in healthy individuals examined in a previous study. Then, the team compared RRMS patients treated with Gilenya to those treated with natalizumab regarding the course of cognitive functions. TysabriĀ is a humanized monoclonal antibody which binds to Ī±4Ī²1-integrin protein; GilenyaĀ is a modulator of the sphingosine 1-phosphate receptor (S1P family of receptors).

Researchers observed that around 75% ofĀ theĀ RRMS patients remained stable over the course of one year of treatment. Moreover, they detected that theirĀ cognitive scoresĀ on tests likeĀ the Paced Auditory Serial Addition Test (PASAT) and the Spatial Recall Test (SPART)Ā showed improvements of 12.5% and 30.6%, respectively. No differences were found in comparisons of cognitive stability between those treated with Gilenya or Tysabri.

In conclusion, results showed that, independent of the type of treatment, the cognitive functions of RRMS patients remained relatively stable under DMT treatment over oneĀ year. Researchers also found that two of the most frequently used cognitive tests (PASAT and SPART) were associated with improvements in a large proportion of thoseĀ under DMT treatment, but emphasized that scores for these two tests should be interpreted cautiously in studies examining performance changes over time.