Multiple Sclerosis Treatment
Medications, physical and occupational therapy, and emotional support are examples of treatment for multiple sclerosis. Medications can help manage flare-ups, modify the course of the disease, and reduce some of the symptoms multiple sclerosis can cause. Physical therapists, occupational therapists, social workers, and counselors can work with your doctor as part of your treatment team.
At this time, there is no cure for multiple sclerosis, but research continues to improve the understanding and treatment of this disease.
Current treatments for multiple sclerosis focus on controlling the immune system and managing the symptoms. It is important for people to work with their healthcare providers to find the best approach to address multiple sclerosis symptoms, such as:
- Extreme fatigue
- Bladder problems
- Spasticity (muscle tightness and spasms).
Specific multiple sclerosis treatment can include:
- Physical or occupational therapy
- Emotional support.
Several medications are available as part of a multiple sclerosis treatment plan. The different categories of medications are discussed in the following paragraphs.
Medications That Manage Exacerbations
MS exacerbations (flare-ups) are usually accompanied by inflammation and breakdown of the myelin in the central nervous system. If your symptoms are severe, high doses of steroids, such as Solu-Medrol®, may be given through an IV to reduce the swelling and inflammation that contribute to demyelination.
Medications That Modify the Disease
A number of newer drugs have been shown to modify the course of multiple sclerosis. These medications work by altering or suppressing the activity of your immune system. A group of drugs called "beta interferons" mimic a protein that occurs naturally in your body. They appear to block certain white blood cells from attacking the myelin covering of the nerves. They also seem to stop other white blood cells, called T cells, from releasing cytokines -- which are chemicals that encourage inflammation and attract other immune cells to the area.
These medications include:
While they don't cure the disease, beta interferons have been shown to reduce the frequency and severity of MS attacks by about 25 percent or more, depending on the dose. These drugs may also reduce the amount of scar tissue that develops in the brain by 70 to 80 percent. With less damage occurring in the central nervous system, the progression of multiple sclerosis symptoms is slowed, possibly reducing the level of disability you may face in the future.
Other medications used in the treatment of multiple sclerosis include Copaxone®, a small protein that resembles a protein found in myelin. The U.S. Food and Drug Administration (FDA) has approved Copaxone for the treatment of relapsing-remitting MS. Copaxone has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one-third.
An immunosuppressant medication, Novantrone® (mitoxantrone), is approved by the FDA for the treatment of advanced or chronic MS. Another disease-modifying MS drug, Tysabri® (natalizumab), is available only through a restricted-access program for people who have found other MS drugs to be ineffective or intolerable, since it can cause very dangerous side effects.
There are two disease-modifying drugs that are taken by mouth rather than injection. The first oral disease-modifying MS drug was Gilenya™ (fingolimod), which is classified as a "sphingosine 1-phosphate receptor modulator."
This medication binds to certain receptors in the body and prevents lymphocytes from leaving the lymph nodes. This decreases the number of lymphocytes in the bloodstream. Lymphocytes, a type of white blood cell, play an important role in the immune system.
The second oral disease-modifying MS medication is Aubagio® (teriflunomide), a pyrimidine synthesis inhibitor. Lymphocytes need pyrimidines to divide and reproduce. By preventing the body from making pyrimidines, Aubagio reduces the number of lymphocytes in the body, which may be the reason it works to prevent MS relapses. Aubagio can cause liver problems and suppression of the immune system and cannot be taken by pregnant women.
Medications That Manage MS Symptoms
There are a few types of medications available to help manage the symptoms of MS, such as:
- Sexual dysfunction
- Slow walking.
These multiple sclerosis treatment options can include things like Botox® or baclofen to reduce muscle stiffness (also known as spasticity). Botox is an injection, and baclofen can be given in pill form or through a small, implantable pump.
Multiple sclerosis can also be managed through deep brain stimulation, which uses a small electrode to stimulate a certain part of the brain. This can reduce the tremors sometimes seen in people with MS.