Treatments of Multiple Sclerosis

Severable different therapies to treat MS are available, although there is still no cure. All treatments have serious side effects. Alternative treatments are chosen by some patients although there is no scientific evidence of their efficacy.

Therapies differ according to the different disease subtypes and the specific symptom or aspect of the disease they aim to manage. Therapies aim mainly to prevent new attacks, return function after an attack and prevent disabilities:

Management of exacerbations – In order to be considered a real relapse, an attack has to last at least 24 hours and happen at least a month after the last exacerbation. However most relapses last several days, or even weeks or months. Attacks are treated with high doses of intravenous corticosteroids in order to reduce the inflammation as soon as possible and leave fewer lasting disabilities on the MS patient. Corticosteroids affect the memory and cause osteoporosis, which is a bone disease leading to bone fragility and an increased risk of fracture. Treatments to modify the disease course – The administration of interferon is the routine therapy used to treat acute relapses. Four different types of interferon are currently used. The use of an immunosuppressant for the treatment of secondary progressive MS has also been approved only in the USA. However, all these medications have modest success in reducing the frequency of the attacks and the progression to disability. Moreover, treatment of primary progressive MS is more difficult than relapsing-remitting MS. In addition to interferon, other medications used are: Natalizumab, a monoclonal antibody - which comparative studies have shown to be one of the most effective drugs currently available. Mitoxantrone – an immunosuppressant – which has given positive results in reducing the progression of the disease. Glatiramer Acetate - which is an immunomodulator.

Interferon has several side effects, which include:

irritation at the injection siteLipoatrophy – a localised loss of fat tissue – can develop with time at the injection siteinfluenza-like symptomssometimes serious liver damage

Glatiramer’s adverse events include:

post-injection effects, such as: flushing, chest tightness, heart palpitation, breathlessness and anxiety, which usually last less than 30 minutes

Mitoxantrone can give:

immunosuppressive effectscardiac toxicity

Management of MS symptoms – MS symptoms tend to worsen as the disease develops, leading to progressive disability. While symptoms vary from mild to severe they can often be successfully managed. Treatments are employed to reduce the progression rate of the disease and include drug therapy, neurorehabilitation, self-care techniques and assistive devices, which are tools or implements which make a particular function easier to perform for a disable. A multidisciplinary approach and a team of different specialists (which can include a physio or occupational therapists, speech/language pathologists and cognitive remediation specialists amongst others) are necessary to tackle symptoms and disabilities. The therapy is then tailored according to the specific symptoms of the patient.

Alternative treatments – include dietary regimen, herbal medicine, medical cannabis, hyperbaric oxygenation therapy – which is the medical use of oxygen at a level higher than in the atmospheric pressure - as well as disciplines like tai chi and yoga to alleviate fatigue. None of these alternative remedies has been scientifically approved.