There are currently six MS treatments approved by the FDA.
The latest treatments for MS (multiple sclerosis) may further improve the quality of life for MS patients. Currently, there are six drugs approved by the FDA for relapsing-remitting MS and medications to battle progressive MS. Patients battling with MS also can take advantage of speech and physical therapies and occupational therapy.
As stated by the National Institute of Neurological Disorders and Stroke, many researchers believe that MS is a disorder in which the autoimmune system attacks the central nervous system (CNS). This causes a thinning or complete loss of the white matter surrounding the nerves, also known as the myelin sheath.
The latest treatment for multiple sclerosis (MS) falls into one of several categories: medication that can reduce activity and progression of relapsing MS; medication for progressive MS; rehabilitation programs can improve the patients function and safety; assistive devices can help the patient manage symptoms.
According to the National MS Society, the FDA has approved six drugs for relapsing-remitting MS. Although these medications are moderately effective at modifying the course and progression of relapsing MS, they have not been thoroughly examined with long-term studies. All of these treatments have significant side effects and require injections as often as daily.
Three of these treatments use formulations of interferons beta-1a (Avonex and Rebif) and beta-1b (Betaseron) to reduce the number of flare-ups and slow the rate of neurological atrophy. Interferons are proteins produced by the immune system that can be highly effective in the treatment of autoimmune disorders like MS. Recent studies show that interferon treatment during an initial attack can help prevent MS. These drugs commonly cause irritation and may destroy fat beneath the skin at the injection site, creating a visible dent in the skin. Interferon treatment can also produce flu-like symptoms.
Glatiramer (Copaxone) is an immunosuppressant primarily used to treat SPMS. It is administered by injection under the skin once a day. Glatiramer can cause anxiety, flushing, breathlessness, heart palpitations and tightness in the chest for up to a half hour after injection. It also creates dents in the skin like the interferon treatments.
Mitoxantrone (Novantrone), is another immunosuppressant that can treat SPMS. It is generally administered once every three months. Mitoxantrone may be the most effective medication for MS but it is severely cardiotoxic, causing a dangerous weakening of the heart muscle that may lead to congestive heart failure. Therefore, it should not be used for more than a few years.
The last of these six treatments is natalizumab (Tysabri). It is prescribed on a limited basis due to a risk of developing a rare brain disorder. Natalizumab is injected only once a month and may be effective in reducing the relapse rate.
Medications are used to reduce flare-ups, control muscle spasms and reduce fatigue in patients with progressive MS. Corticosteroids are administered orally or intravenously to reduce inflammation and control flare-ups. Baclofen (Lioresal) and tizanidine (Zanaflex) are oral muscle relaxants for treating spasms, particularly in the legs. Various stimulants may be effective in treating fatigue related to MS.
Physical therapy most often refers to exercises to stretch muscles and increase range of motion. MS patients can engage in aerobic exercises, such as walking or riding a stationary bike, designed to strengthen upper arm muscles and upper body control. A therapist may also provide instructions on how to fall safely.
Speech therapy for MS is designed to reduce long pauses, slurring and nasal sounds in the speech. It may also be used to improve speech patterns, enunciation and general verbal communication. Speech therapy can also help identify swallowing problems and make swallowing easier.
The purpose of cognitive retraining is to improve mental impairment that may be caused by MS such as memory difficulties. Cognitive therapy can also help identify factors, such as anxiety, depression and stress that may interfere with cognitive ability.
Patients with MS usually receive an assessment to determine their need for assistive devices like walkers and wheelchairs. Occupational therapy will include instructions on the use and care of these devices. Patients needing a wheelchair also learn how to move to an automobile, bath bed or bathtub.
There is hope that additional treatments will become available in the near future. For example, aminopyridines may improve the conduction of neural impulses through the areas affected by MS. In initial studies, patients treated with 4-aminopyridine have tolerated it well, and they have also experienced improvements in coordination, strength and vision. Another drug called fingolimod, which is taken as a pill rather than through injection, prevented relapses in 67 percent of patients involved in a three-year study and reduced overall disease activity. Studies show it to be just as effective as other medications, excluding natalizumab. A method of implanting oligodendrocytes directly into the brain has recently been developed and may be helpful in treating cases of MS that are not the result of an autoimmune response.
Many organizations maintain information on the latest treatments for MS. The Multiple Sclerosis Association of America, Multiple Sclerosis Foundation and the National Multiple Sclerosis Society provide an array of direct support services for individuals and support services for family members. To learn more about MS, patients can visit the Accelerated Cure Project for Multiple Sclerosis, which maintains an extensive and detailed database of information and research.