Common Multiple Sclerosis Treatments: An Overview

A debilitating disease that was once the face of a crushing and “hopeless” diagnosis has evolved from having one effective treatment to multiple effective treatments. Longtime sufferers who didn’t respond to one medication now have options to try others, to participate in a clinical trial or stem cell therapy, holistic approaches, and other types of treatments now available.

Like so many other diseases, multiple sclerosis is no longer seen as a depressing, progressive illness that results in untimely debilitation.

Multiple sclerosis treatments can be administered several different ways depending on the drug. Some drugs are administered orally, some require patient injection, and others require the patient to undergo infusion therapy. Some of the most well known and FDA-approved infusion therapies are outlined here.

Copaxone

Copaxone is a drug that requires the patient to inject themselves every other day or once every 3 days, depending on the patients comfortability and dosage tolerance. Some patients have a difficult time tolerating injections every other day due to side effects, whereas other patients don’t have issues doing either. What is unique about copaxone is that it requires the patient to inject a different fatty area on the body everytime. The patient will keep a record of where they have injected themselves previously, and avoid that area until all other areas have been injected.

The injection site rotation is mainly due to the injection site reaction that occurs on every patient. This reaction involves hardening of the area, pain at injection site, itchiness, and swelling. Copaxones main function is to prevent future MS episodes while allowing the body to heal itself in the interim.

Ocrevus

Ocrevus is another infusion drug that requires the patient to visit a healthcare facility to be infused every 6 months. The initial infusion is given at a half dose, the patient waits 2 weeks, then another half dose is administered. If the patient doesn’t have any negative reactions to the drug during this time, the full dose is administered 6 months after the last half dose, and every six months after that. Ocrevus acts as an immunosuppressant but not in the traditional sense.

Ocrevus suppresses the cells that are believed to be responsible for attacking the myelin sheath around the nerves. The immune system is still able to function on a normal level and doesn’t leave the patient at a significantly higher risk of illness or infection like other immunosuppressants do.

Lemtrada

Lemtrada is an immunosuppressant drug that has significantly more dangerous side effects than the two previous medications listed. Lemtrada’s initial mode of action is to wipe target proteins and lymphocytes within the immune system and destroy them. The exact mode of action isn’t known, but it essentially wipes the immune system in hopes it will regenerate in a more normal form, without attacking the myelin sheath on the nerves. Lemtrada is usually given to patients who haven’t responded well to 2 or more other drugs, and is also correlated with a high fatality rate due to infection, malignancies, and other illnesses indirectly related to the infusion. Although known to be incredibly successful for some patients, many doctors avoid recommending lemtrada due to its side effects and potentially fatal complications.

Interferons

Interferons are actually signaling proteins found within the body that are released when the body is sick or comes in contact with certain pathogens. As an integral part of the immune response, interferons “interfere” with virus replication, activate natural killer cells to fight infection, along with other necessary immune system functions. Interferons are able to stop the body from attacking itself from within, and focus the cells attention on outside pathogens, hopefully lessening the damage caused by autoimmune diseases. This treatment is also used to treat cancers and helps with multiple other autoimmune diseases.

Novantrone

Novantrone was initially approved for treatment of prostate cancer in men, but soon proved to be effective in the treatment of multiple sclerosis. This drug works by suppressing the cells that are known to attack the myelin sheath in multiple sclerosis patients; B cells, T cells, and macrophages. Multiple sclerosis patients with cardiac health problems are not able to take Novantrone due to the heightened risk of cardiac related issues. This drug focuses on preventing neurologic disability and relapse in multiple sclerosis patients.

Tysabri

This drug is used to treat both multiple sclerosis and Crohn's disease. It’s main function involves interfering and “hampering” immune cells ability to move through to body. Because immune cells are the cells responsible for demyelination in the nerves, Tysabri works by slowing and/or stopping the cells ability to reach their destination. Tysabri modifies the disease course and has been shown to be very effective in doing so.

Oral treatments for multiple sclerosis

Aubagio

Aubagio is an oral medication that targets one of the key enzymes that is responsible for demyelination. Attacking the enzyme prohibits B and T cells from causing any more damage while also releasing messenger cells to promote recovery.

Tecfidera

Tecfidera works by preventing relapse or multiple sclerosis related events within the immune system. Due to the side effects associated with the drug, your doctor will usually start you off at a low dose for a week before heightening your dosage to the full milligrams. This medicines known side effect is flushing of the face. Taking an aspirin 30 minutes before taking Tecfidera has been known to prevent flushing after your dose.

Symptomatic treatment options

Nuedexta

This drug was originally approved to prevent sudden outbursts of crying or laughing, but has now been shown to benefit patients with multiple sclerosis as well. This drug isn’t approved to treat multiple sclerosis in general, only to prevent these emotional outbursts that people with multiple sclerosis can experience.

Gilenya

Gilenya is approved for use to treat multiple sclerosis flare-ups. MS flare-ups can be debilitating and cause patients to be bedridden for days on end. This drug helps to get patients back on their feet after a flare up, and feeling normal again.

Ampyra

A common and frustrating symptom of multiple sclerosis is trouble walking. Being unable to get from point A to point B without assistance walking is not only upsetting, but disheartening. Much can be said for patients who still have their mobility and are able to maintain independent lifestyles. Ampyra is used to treat patients who are experiencing difficult walking, and helps them get their mobility back.

Corticosteroids

Steroids have been one of the main go-tos for doctors who are treating MS patients with flare-ups. Corticosteroids are incredible effective in diminishing anti-inflammatory responses in patients including multiple sclerosis patients.

So, what else is out there?

For patients being treated with medication, it’s important to lead an overall healthy lifestyle as well. Some patients refuse modern medicine and embrace an overall wellness approach. Although effective for some patients, it is recommended to exercise and eat healthy in conjunction with a medication that prevents the progression of the disease.

One of the best things multiple sclerosis patients can do for their bodies is to remain active as long as possible. It might be difficult for some patients to walk, but getting outside and immersing yourself nature has numerous health benefits beyond your physical state. Many patients work with professionals in cognitive rehabilitation, helping them to get their memory back and keep their brain working.

Keeping your mind alert and active is incredible important for MS patients, even on days when brain fog takes over. Speech therapy is effective in helping patients who are having difficulty speaking or comprehending speech.
Aside from modern medicine, there are numerous options out there for multiple sclerosis patients, all it takes is a little research and a talking with your physician.

References

http://www.health.com/health/gallery/0,,20639125,00.html

https://multiplesclerosisnewstoday.com/

https://www.nationalmssociety.org/Treating-MS/Medications