Watershed in MS treatment progress

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It used to be that a person diagnosed with multiple sclerosis (MS) was often subject to the dismal prognosis of a gradually but inexorably progressive disease. But developments over recent years are starting to change that outlook. New and more sophisticated drugs have been approved, and more are currently in Phase 3 clinical trials. So, patients with MS can now be more optimistic abut their future than ever before. As Dr. Timothy Coetzee, chief research officer of the National Multiple Sclerosis Society, puts it, We have a disease that s gone from having no treatments 20 years ago to having multiple treatment options ¦ MS is becoming a manageable disease.

Multiple sclerosis affects the central nervous system (CNS), the nerve cells of the brain and spinal cord. It s an auto-immune disorder in which the body s own immune system damages the CNS neurons. Most patients develop what s called relapsing-remitting MS, which is characterized by symptom flare-ups, which include difficulty walking, muscle weakness, or vision problems, that mostly disappear until the next attack. Yet even in these patients, there is a gradual deterioration over time.

Fortunately, the newest drugs are able not only to reduce the frequency of these relapses, but they also slow the progression of the disease. There are currently eight disease-modifying drugs available that reduce relapses, some of which also prevent the death of brain neurons a significant factor in avoiding permanent disability. Additionally, in just the past two years, three drugs have been approved to treat specific MS symptoms, including difficulty walking, urinary incontinence, and spasticity in the limbs. The first oral drug for MS, Gilenya, was approved last year; it cuts the rate of relapse by 55 percent. And the most potent MS drug, Tysabri, reduces relapses by an impressive 70 percent. Although there are some concerns about side effects with these drugs (Tysabri, for instance, carries a small risk of a particular brain infection from a common virus, so patients must be screened beforehand for viral antibodies), other new options may have even fewer side effects, while also protecting against the progression of permanent disability.

One especially important difference in the new generation of drugs is that they target the disease much more specifically, homing in on specific molecules involved in MS. Older medications, mostly interferon drugs, worked by suppressing the immune system which comes with a much greater risk of side effects.

ACSH s Dr. Gilbert Ross is quite impressed with the progress that has been made over the past decade in the battle against MS. These drugs represent another near-miraculous breakthrough, along with immune-modulating drugs for rheumatoid arthritis and medication for AIDS. he says. It s really revolutionary how, just over the past ten years, we ve taken great strides toward controlling MS, a disease long felt to be an irrevocable sentence of severe disability and, frequently, death.