MULTIPLE sclerosis campaigners have hailed a “huge step forward” for patients in Scotland after a stem cell therapy was recommended for use on the NHS for the first time.
Haematopoietic stem cell transplantation (HSCT) has been described as a “game-changer” for MS after an international clinical trial showed that it could reboot patients’ immune systems and halt the progress of the disease.
Some patients who had been in wheelchairs prior to treatment said their condition improved so dramatically it was like they had never been diagnosed with MS.
The Scottish Health Technologies Group (SHTG) said there is now sufficient evidence for it to recommend making HSCT available on the NHS in Scotland to MS patients who have the relapsing-remitting form of the disease, and who were not responding to drug treatments.
Iain Robertson, chairman of the SHTG, said: “Our committee members were able to advise that this treatment should be considered for those with this particular type of MS who have not responded to treatment with disease-modifying therapies.
“We hope that our advice will be of use in helping decide the best course of treatment for these patients.”
The SHTG also stressed that patients must be made aware of the “demands, risks and uncertainties” of the treatment, which uses chemotherapy to wipe out patients’ ‘faulty’ immune systems before replenishing it with a transplant of stem cells harvested from their own bone marrow.
It puts patients at high risk from infections, which can be fatal, but the theory is that the treatment works by enabling patients to ‘reset’ their immune system to stop it attacking the central nervous system – as is the case in MS.
HSCT is not considered an effective treatment for patients with the progressive form of MS, however, as stem cells cannot regrow nerves or repair damaged myelin – the protective sheath which coats nerves.
It will also be unavailable to patients with relapsing-remitting MS who no longer show signs of inflammation on an MRI brain scan.
Scotland has one of the highest rates of MS in the world, but until now Scottish patients seeking HSCT have had to travel overseas to Mexico, Russia and Israel and bankroll their own private treatment at a cost of around £40-60,000.
It has also been available privately in London since 2017, but with a £100,000 price tag.
A small number of MS patients in England have been able to access the treatment on the NHS, however, because there are clinical trials into HSCT taking place at NHS hospitals in Sheffield and London.
Morna Simpkins, director of MS Society Scotland, said: “The decision from SHTG to approve HSCT for the treatment of MS is good news and could help in the development of a clear pathway, for people who could potentially benefit, to access it.
“We will push to ensure that this decision leads to real change for people with MS by continuing to engage with other groups to offer the treatments, including HSCT, which are right for them.”
The SHTG said eligible patients must have equal access to the procedures regardless of where they live, but it is unlikely all health boards will be able to provide it.
The MS Society wants a centre, or centres, of excellence set up where patients from across Scotland can be referred.
Lucy Clarke from the Scottish HSCT Network said the recommendation was “a huge step forward” for people in Scotland living with MS.
Ms Clarke underwent HSCT in Russia and credits it with substantially reversing her disability.
She added: “This important decision supports HSCT as a treatment option where other treatments have failed. We will continue to push so that this treatment is available to people in Scotland who need it.”
A Scottish Government spokeswoman said: “We are grateful to the Scottish Health Technologies Group for this important work.
“NHS Boards are expected to consider their advice on technologies in the planning and provision of its services and clinicians are expected to follow their professional judgement, working within the management structure of their Board.
“We will work closely with MS Society Scotland, other third sector bodies and the clinical community to consider what the Technologies Group’s findings means for provision in Scotland, including the information that needs to be available to people about eligibility and risks.”