Editor’s note: This is the final of a three-part series examining multiple sclerosis and actions that can control this auto-immune disease that attacks the central nervous system. MS can’t be cured, but numerous drugs and therapies are available to manage symptoms, slow disease progression and improve quality of life.
As recently as 35 years ago, people who contracted multiple sclerosis had few options to control a mysterious disease that most often hits women in the 20- to 40-year-old range. Research was ongoing and optimistic. However, those who were interviewed about their diagnosis at the time feared otherwise.
Since 1995, numerous alternatives have become available and the medical world is learning that specific therapies can improve the quality of life for those with specific symptoms.
A drug called Interferon Beta-1B became the first drug proven to alter the natural history of relapsing-remitting MS. Soon afterward, two additional drugs were approved by the FDA that became known as the ABC drugs because of their brand names.
This class of medications work by interacting with the immune system to reduce inflammation that attacks the central nervous system. They are typically administered through injection.
Doctors at Mayo Clinic continue to use interferon beta remedies when they are warranted, but two other injectable treatments are now available, depending on the individual. They include
Glatiramer Acetone, a medication that can help block the immune system’s attack on myelin. The other is called Ofatumumab, which targets cells that damage the nervous system.
In addition, Mayo Clinic now has in its arsenal nine separate oral treatments that can be used to best help the patient. These medications are capable of doing everything from reducing relapse rates in MS to being a second-line treatment.
They include: Teriflunomide, which reduces relapses; Dimethyl Fumarate, reduces relapses; Diroximel Fumarate, is like the previous, but has fewer side effects; Monomethyl Fumarate is a delayed release medicine with a slow and steady action; Fingolimod reduces relapse rates; Siponimod helps slow progression of MS; Ozanimod decreases relapse rates; Ponesimod is one of gradually increasing dosage for obscure diagnoses and Cladribine is a second-line treatment for relapse as well as for secondary progressive MS.
Mayo Clinic has four infusion treatments available. They include Natalizumab, a monoclonal antibody that slows down the risk of the disability; Ocrelizumab, which treats relapsing and primary progressive forms of MS; Ublituximab is a monclonal antibody used to treat relapsing forms of MS and finally, Alemtuzumab is a monoclonal antibody that decreases annual relapse rates and demonstrates MRI benefits.
The above-named therapies are also available at numerous other medical facilities. The information for this article, however, was provided by Mayo Clinic. Research is ongoing to find even more options.
But it doesn’t stop with drugs specific to MS. Other treatments can help relieve some of the symptoms. They include occupational therapy that can teach stretching and strengthening exercises.
Muscle relaxants are often used if the patient experiences muscle stiffness or spasms, particularly in the legs. One of them is Botox that is used as a treatment for muscle contractions.
Doctors may prescribe medicines to reduce fatigue. They include Ritalin and Provigil that are used to reduce MS-related fatigue. Some medicines normally used to treat depression such as Prozac and Wellbutrin may be recommended as well. However, more research is needed to better qualify these choices.
A drug called Amyra may be used to slightly increase walking speed in patients and other medicines used for depression, pain, sexual dysfunction, insomnia and bladder or bowel control problems that are linked to MS.
The most recent developments include a therapy called BTK inhibitor that alters the function of B cells, stem cell transplants that destroys an immune system with MS and replaces it with healthy cells and a new medicine called Phosphodiesterase Inhibitor that works to decrease inflammation by changing damaging immune system responses seen in MS.
As with any drug, these therapies have certain side effects, so it’s crucial that doctor and patient both understand what is best for each individual’s condition.
