What is the effect of treatments for multiple sclerosis?
Before treatment, if you did natural history, in other words, if you followed patients for ten, fifteen, or twenty years, what happened to them? Well, at the end of ten years fifty percent of them would disabled. They would be blind, they would be unable to walk, or they would have cognitive difficulties. So they would be disabled. With these treatments disability after ten years is somewhere between eight percent and twenty-five percent. Which means ninety-two percent are not disabled, or eighty percent are not disabled. So that's the major impact. Some of the drugs we haven't been able to study for ten years yet, we don't know, but quite clearly the ones we have studied have made a major impact on disability which is really very, very critical. Disability is associated with axonal damage, with nerve damage and if you can prevent that you will not have disabled patients. My feeling right now is that if a patient is diagnosed now, with their first episode and they're put on treatment they have a very little chance of being disabled. About a ten percent chance of being disabled, which I would not have said five years ago or ten years ago.
