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Modafinil Reduces Cytokine-induced Fatigue in Multiple Sclerosis Patients: Presented at ANA

By Thomas S. May
Special to DG News

NEW YORK, NY -- October 16 -- Modafinil significantly reduces fatigue induced by cytokine therapy in a subset of Multiple Sclerosis (MS) patients, according to results presented here October 15 at the 127^th annual meeting of the American Neurological Association.

Dr. Lauren B. Krupp and colleagues at State University of New York at Stony Brook, Stony Brook, New York, United States, enrolled 18 MS patients who were on standard intramuscular interferon (INF-b-1a) therapy in a two-week-long study designed to investigate the effects of Modafinil on cytokine-induced fatigue.

A group of eight patients who reported increased fatigue after injection (induced group) was compared with 10 patients whose fatigue was independent of timing of INF-b injection (non-induced group) on measures of fatigue, affect, and cognition.

Patients were evaluated (1) immediately before IFN-b-1a injection; (2) one day after IFN-b-1a injection; and (3) two weeks later, following IFN-b-1a injection. Between times 2 and 3, the induced group received daily modafinil, the non-induced group did not.

Compared with the non-induced group, the induced group showed increased fatigue and decreased positive affect between times 1 and 2, and decreased fatigue and increased positive affect after modafinil treatment between times 2 and 3. The differences were statistically significant (p<0.05). No differences could be observed between the groups for negative affect or cognition.

The researchers concluded that modafinil significantly reduces cytokine-induced fatigue, and that cytokine-induced fatigue is associated with decreased positive affect. In addition, by showing that fatigue can be acutely induced by cytokine therapy in a subset of MS patients, the study provides a model for further fatigue research, the authors contend.

"Fatigue is a common disabling MS symptom. Demonstrating that it can be reduced with medication is a great benefit to patients and clinicians," Dr. Krupp said.

She also commented that "a unique aspect of this study was the timing of fatigue, mood, and cognition assessments before and after a procedure known to induce fatigue. This provided an opportunity to examine changes before and after a physiologically altered state," Dr. Krupp explained.

The research was funded by Biogen Cephalon, the makers of modafinil (Provigil).

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