Treatments for Multiple Sclerosis - Madi Hand

There are so many things in the world that are out of our hands. The first thing that comes to my mind is neurological diseases because in most cases these are genetic so it is not much you can do to prevent them. For example, Multiple sclerosis is partially genetic, however, there are risk factors that could increase one's risk of developing this disease (Lassmann). Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease, meaning it is because of focal lesions in the white and gray matter that diffuse neurodegenerative neurons in the brain (Lassmann). In the brain, lesions trick the human immune system to attack the protective sheath that covers nerve fibers. Once the brain when the myelin sheath reaches a point where there is no protection, permanent damage begins, meaning the deterioration of the nerves cannot grow back (Patsopoulos).

When it comes to treatments there are different ways to approach it, many researchers focus on disease-modifying therapies. As more disease-modifying therapies (DMT) are developed it continues to reduce the frequency of relapses of MS making it easier for people living with this disease. The main goal of this therapy is to reduce the early clinical disease activity that is known to contribute to long-term disabilities (Hart).

A trial with Alemtuzumab (which is a DMT), “given 3 times weekly, and showed superior efficacy in both trials… annualized relapse rate was 52%, then patients receiving Alemtuzumab had a 26% relapse rate” (Hart). They observed that they had more successful results when the treatment was initiated early during MS (Noyes).

A common type of drug that is given to MS patients is corticosteroids, which increase the hormone cortisol in your body (Negaresh). Cortisol helps your body manage blood glucose levels as well as the metabolism of proteins and carbohydrates (Negaresh). Another common treatment is plasma exchange, which means taking the plasma out of your blood and mixing it with a high protein solution then returning it back into the body, this is used for decreasing symptoms that are severe and do not respond to steroids (Negaresh). Both treatments are used to slow the development of symptoms, not necessarily stop all the symptoms. 

            Overall, there is no cure for MS, however, research has been done to prove that there are treatments to help improve the quality of life of MS patients. These treatments include corticosteroids, plasma exchange, physical therapy, muscle relaxants, yoga and aquatics, coordination therapy, and of course medications to lessen specific symptoms. Researchers have made a lot of progress with treatments, however much more is needed to make real improvements within the MS community. With the correct treatment and therapy, MS patients can very much so live a somewhat normal life, many even continue to work their jobs years after being diagnosed (Kleinman).

Hart FM, Bainbridge J. Current, and emerging treatment of multiple sclerosis. Am J Manag Care. 2016 Jun;22(6 Suppl): s159-70. PMID: 27356025.

Kleinman NL, Beren IA, Rajagopalan K, Brook RA. Medication adherence with disease-modifying treatments for multiple sclerosis among US employees. J Med Econ. 2010;13(4):633-40. doi: 10.3111/13696998.2010.527588. Epub 2010 Oct 19. PMID: 20958113.

Lassmann H. Multiple Sclerosis Pathology. Cold Spring Harb Perspect Med. 2018 Mar 1;8(3): a028936. doi: 10.1101/cshperspect. a028936. PMID: 29358320; PMCID: PMC5830904.

Negaresh R, Motl R, Mokhtarzade M, Ranjbar R, Majdinasab N, Khodadoost M, Zimmer P, Baker JS, Patel D. Effect of Short-Term Interval Exercise Training on Fatigue, Depression, and Fitness in Normal Weight vs. Overweight Person with Multiple Sclerosis. Explore (NY). 2019 Mar-Apr;15(2):134-141. doi: 10.1016/j.explore.2018.07.007. Epub 2018 Jul 20. PMID: 30122328.

Noyes K, Weinstock-Guttman B. Impact of diagnosis and early treatment on the course of multiple sclerosis. Am J Manag Care. 2013 Nov;19(17 Suppl): s321-31. PMID: 24494633.

Patsopoulos NA. Genetics of Multiple Sclerosis: An Overview and New Directions. Cold Spring Harb Perspect Med. 2018 Jul 2;8(7): a028951. doi: 10.1101/cshperspect. a028951. PMID: 29440325; PMCID: PMC6027932