Now
Taking a lesson
from failure
by Dr. Timothy Coetzee
“One fails forward toward
success.” —Charles Kettering,
American inventor and
philanthropist
At the end of the 1980s, the late Hillel Panitch, MD,
and colleagues administered the
immune molecule interferon
gamma to 18 people with MS,
with very negative results—MS
worsened in seven of them.
Lancet 1987;1:893–5. But that
study helped to steer research in
the direction of a related molecule, interferon beta. Now there
are several effective MS therapies
based on interferon beta.
Failing is normal when you’re
taking risks, and it’s not all bad
if we are open to the lessons that
failures teach us. We might be seeing another success story in action
right now. John Noseworthy,
MD, and colleagues tested
linomide—a drug that modulated
the immune system—in a phase
III trial of 715 people with MS.
Earlier studies had shown benefit.
Unfortunately, one month after all
patients were enrolled, the study
had to be terminated when people
developed severe heart problems.
Neurology 2000;54: 1726–1733
Just two years later, lab studies on “a new immunoregulator
derived from linomide” showed
that this molecule could suppress an autoimmune response
Top 5 Reasons
Why People
Participate
in Clinical
Trials
Percent of Respondents
To advance medicine 51 To ;nd a better treatment for my condition 46 To help others with my condition 39 To earn extra money 36 My doctor recommended it 31%
More than 52,000 people with MS participated, or are participating in the
studies listed in the National MS Society’s 2011 list of Clinical Trials in MS.
Our hats go off to those who are helping MS research to “fail forward” and
are moving us closer to a world free of MS.
in rats. Neuropharmacology
2002;42:731–9 Now, this immunoregulator—laquinimod—has
produced positive results in its
first phase III study of 1106 people with relapsing MS, sponsored
by Teva Pharmaceutical Industries. It appears to slow progression and brain tissue loss, among
other findings, and was generally
well tolerated. (We should learn
more details about it in coming
months.)
Failure in research is a part of
life in the research lab and in the
clinic. But we can do our best to
ensure that MS research always
“fails forward.” For one thing, as
much as possible, clinical trials
should be designed to provide
information about MS that we
can use no matter the outcomes
of that particular trial.
Daniel Reich, MD, PhD, and
colleagues at the NIH are recruit-
ing 80 people with primary-
progressive MS to evaluate the
safety and effectiveness of ide-
benone, a man-made drug that
is similar to a naturally occur-
ring antioxidant. Participation
includes five pre-treatment clinic
visits, where investigators will
gather extensive information
about this troublesome and less
common type of MS.
