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Multiple Sclerosis - Treatment to Reduce Symptoms and Modify course of Disease
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Multiple Sclerosis – Treatment to Reduce Symptoms and Modify course of Disease

Last Updated on Jun 22, 2018
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Multiple sclerosis is treated with drugs that modify the course of the disease, suppress immunity and relieve the symptoms.

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Multiple sclerosis is an autoimmune disease wherein the patient produces ‘antibodies’ or proteins that damage the covering of nerve fibers. This is followed by damage to the nerve itself. Thus the nerve is not able to function properly leading to symptoms like decreased sensations, inability to move some muscles or balance depending on the nerve involved. The condition may progress to such an extent that the patient may be totally disabled and need complete care.

Medications used in multiple sclerosis include:

Drugs that modify the course of the disease

Drugs that act on the immune system help to modify the course of the disease.  The preferred drugs are beta – interferon and glatiramer acetate. These drugs reduce the relapses of multiple sclerosis. Other drugs are also available but they can cause serious side effects. They are used only if the above two drugs are not effective or if they cause side effects. These second-line drugs are mitoxantrone and natalizumab. Mitoxantrone causes side effects like damage to the heart, leukemia, low white blood cell counts, infections, problems with menstruation and infertility.  Natalizumab can cause progressive multifocal leucoencephalopathy, a condition that affects the brain and can result in death or disability. Natalizumab was voluntarily withdrawn by its manufacturer due to this side effect but was later reintroduced since some multiple sclerosis patients were willing to take the risk.

Drugs that suppress immunity:

These drugs include azathioprine, cyclophosphamide, methotrexate, mycophenolate mofetil and corticosteroids. They reduce immunity, thus reducing the damage on the nerves and nerve coverings.

Drugs that reduce symptoms:

Drugs used to reduce the symptoms of multiple sclerosis are:

Corticosteroids reduce inflammation and flare ups of the disease

Muscle relaxants such as baclofen and tizanidine reduce muscle spasms

Amantadine, modanafil, aspirin are useful in fatigue caused by multiple sclerosis

Tolterodine – helps to control urinary symptoms such as frequency and urgency

Antidepressants help to control depression associated with the disease

Gabapentine is useful for burning feet.

Vitamin D has also been found to have a protective effect in multiple sclerosis

Besides drugs, physiotherapy, occupational therapy, avoiding extreme heat and a well balanced diet are also important in the treatment of multiple sclerosis. Patients with severe disease not responding to steroids may undergo a procedure called plasmapheresis in which the antibodies are filtered out from the blood.

What is new in Multiple Sclerosis ?

1. Multiple Sclerosis Patients can Now be Monitored Better With Algorithms

Algorithm created by the University of Sheffield and Sheffield Teaching Hospitals researchers may now help collect real time data to improve monitoring of treatments and disease progression in multiple sclerosis patients.

Reference – Multiple Sclerosis

  1. Coyle PK. Disease-modifying agents in multiple sclerosis. Ann Indian Acad Neurol. 2009 Oct–Dec; 12(4): 273–282.
  2. Gasperini C, Ruggieri S, Pozzilli C. Emerging oral treatments in multiple sclerosis – clinical utility of cladribine tablets. Therapeutics and Clinical Risk Management 2010; (6): 391–399
  3. Goodman AD, Brown TR,  Krupp LB, Schapiro RT, Schwid SR, Cohen R, Marinucci LN, Blight AR, on behalf of the Fampridine MS-F203 Investigators. Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial.  The Lancet 2009; 373 (9665): 732-8.
  4. Calabresi PA. Diagnosis and Management of Multiple Sclerosis. Am Fam Physician. 2004 Nov 15;70(10):1935-1944.
  5. Harrison’s Principles of Internal Medicine 17th Edition.

Latest Publications and Research on Multiple Sclerosis Treatment and Modify

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Comments

jj._-

When will dalfampridine be available in India?

peanut03

Are these oral pills for Multiple Sclerosis prescribed by Doctors in India. Would be interested in knowing about Jaipur and Pune

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