Cancer pill 'offers MS benefits'

The long-term mortality would be a concern with a drug that suppresses the immune system. Much caution needed

Courses of a common cancer drug can dramatically reduce the risk of a patient with multiple sclerosis having a relapse or deterioration, work shows. Taking cladribine a few times a year more than halved the chances of a relapse, with few side-effects, the UK study of 1,300 patients found.

UK expert Professor Gavin Giovannoni said the drug could revolutionise the treatment of MS. Its manufacturer Merck Serono hopes to seek licensing for its use this year. The drug is already licensed for treating leukaemia. Prof Giovannoni gave his assessment of its potential value to MS patients at a meeting of the American Academy of Neurology in Seattle.

The UK's drugs watchdog, the National Institute for Health and Clinical Excellence, is considering including cladribine in its next round of assessments.

Cladribine works by suppressing the immune system, reducing the risk of further damage to a patient's nervous system. Patients who took the drug were 30% less likely to suffer worsening in their disability due to MS. The study involved over 1,300 MS patients who were followed up for nearly two years and monitored using MRI scans. Patients were given either two or four treatment courses of cladribine tablets per year, or a placebo.

Each course consists of a single tablet per day for four or five days, adding up to just eight to 20 days of treatment each year. If it becomes available to patients, cladribine will be the first licensed treatment for MS which does not involve regular injections.

Professor Giovannoni, of Barts and The London School of Medicine and Dentistry, part of Queen Mary, University of London, said: "These results are really exciting. MS can be a very debilitating illness and at the moment treatment options remain limited. "Having an effective oral therapy will have a major impact for people with MS. "Our study shows that cladribine tablets prevent relapses and slow down the progression of the disease, making patients feel better. "Importantly, it does so without the need for constant injections that are associated with unpleasant side-effects. "We will continue to follow the patients in the trial to see how they fare in the long-term."

Dr Lee Dunster, head of research at the MS Society, said: "These are remarkable results and being able to take a tablet instead of having injections will be a huge step forward for people with MS. "The evidence is there, but we now need to see cladribine move smoothly through the regulatory process and the price the manufacturer sets will play a crucial part in that."

It is estimated that 85,000 people in the UK currently have MS, with 2,500 new cases diagnosed each year.

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Lithium in water 'curbs suicide'

Drinking water which contains the element lithium may reduce the risk of suicide, a Japanese study suggests. Researchers examined levels of lithium in drinking water and suicide rates in the prefecture of Oita, which has a population of more than one million. The suicide rate was significantly lower in those areas with the highest levels of the element, they wrote in the British Journal of Psychiatry.

High doses of lithium are already used to treat serious mood disorders. But the team from the universities of Oita and Hiroshima found that even relatively low levels appeared to have a positive impact of suicide rates. Levels ranged from 0.7 to 59 micrograms per litre. The researchers speculated that while these levels were low, there may be a cumulative protective effect on the brain from years of drinking this tap water.

At least one previous study has suggested an association between lithium in tap water and suicide. That research on data collected from the 1980s also found a significantly lower rate of suicide in areas with relatively high lithium levels.

The Japanese researchers called for further research in other countries but they stopped short of any suggestion that lithium be added to drinking water. The discussion around adding fluoride to water to protect dental health has proved controversial - criticised by some as mass involuntary medication.

In an accompanying editorial, Professor Allan Young of Vancouver's Institute for Mental Health said "this intriguing data should provoke further research. "Large-scale trials involving the addition of lithium to drinking water supplies may then be feasible, although this would undoubtedly be subject to considerable debate. Following up on these findings will not be straightforward or inexpensive, but the eventual benefits for community mental health may be considerable."

Sophie Corlett, external relations director at mental health charity Mind said the research "certainly merits more investigation. "We already know that lithium can act as a powerful mood stabiliser for people with bipolar disorder, and treating people with lithium is also associated with lower suicide rates. "However, lithium also has significant and an unpleasant side effects in higher doses, and can be toxic. Any suggestion that it should be added, even in tiny amounts, to drinking water should be treated with caution and researched very thoroughly."

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Swine flu hype fading: "Scientists are coming to the conclusion that the new strain of swine flu that has killed at least ten people around the world may actually be less dangerous than the average annual flu season. The World Health Organisation is expected to move quickly to designate a full pandemic - at level 6 of its 6-point scale - within days to reflect the continuing spread of swine flu among people who have not been to Mexico, including in Europe. But, though some people have died, the most common complaint from sufferers infected with the virus has been diarrhoea - and, despite the hype, the rate of infection appears to be more of a trickle than a deluge. This morning the World Health Organisation said on its website that as of 6am GMT, swine flu had infected 331 people in 11 countries, killing ten of them. Other estimates of the infections and deaths are higher - for instance Mexico says up to 176 people have died there and the authorities have confirmed 12 deaths. However, despite the variations, the numbers are still relatively small - and they don't seem to be multiplying"