Introduction of Multiple Sclerosis (MS)
Multiple Sclerosis (MS) is a chronic condition in which the Central Nervous System is involved and causes temporary lesions and inflammation. Myelin is attacked by the immune system and leads to lasting lesions. When a person is diagnosed with MS, they begin looking for treatment. There are several treatments, from managing symptoms to rehabilitation strategies, but there is no hard and fast cure for MS. Let’s explore medication and other treatments that can be used to manage symptoms of MS.
Treatments Available for Multiple Sclerosis (MS)
Disease-Modifying Therapies
The progression of the disease can be slowed by Disease-Modifying Therapies (DMTs). This is the first step in lowering the relapse rate. The number and size of lesions can be decreased by DMTs. It works by restraining the immune system and eventually slowing the progression of the disease. Right after the diagnosis of MS, DMTs are prescribed to the patient by the doctor. There are three basic forms of DMTs: oral therapies, IV infusion, and injections.
Injections
There are two ways to inject DMTS: intramuscular or subcutaneous.
- Beta-Interferons
The most common drugs given to treat MS are Beta Interferons. Avonex, Rebif (interferon beta-1a)- Betaseron, Extavia (interferon beta-1b)- Plegridy (peginterferon beta-1a) are the Beta interferon drugs used for MS. The frequency of flares and severity of the disease can be reduced by these drugs. They have their own minor side effects by slowing the progression of the disease by decreasing the number of white blood cells (WBCs). Decreasing WBCs can lead to minor infection or flu-like symptoms, but it actually helps the immune system fight the illness.
- Glatiramer (Copaxone, Glatopa)
Glatiramer is used to stop the attack of the immune system on myelin. The attack disturbs the surrounding nerves and leads to a severe condition, but this medication protects myelin. The side effects include anxiety or elevated heart rate, but these are the short-term outcomes of the medication, and do not necessarily reflect what long-term effects could be.
Oral Therapies
There are people who feel difficulty in bearing injections. Doctors prescribe them oral therapies.
- Fingolimod (Gilenya)
Gilenya needs to be taken once a day. These pills restrain the disease from creating lesions on the spinal cord and brain by entrapping immune cells in lymph nodes. These pills can only be taken if prescribed, though it is FDA approved but have side effects. The common side effects of Gilenya include diarrhea, headache, abnormal liver test, sinus inflammation, pain in arms and legs, and cough.
- Dimethyl Fumarate (Techfidera)
A patient with MS needs to take Tecfidera pills twice a day. These pills activate the response that protects the cells in distress. Regular blood tests are required because Tecfidera lowers the immune cells in the body. The most common side effects include nausea, flushing, diarrhea, and stomach pain. Severe side effects can also be led by Tecfidera, including allergic reaction, Progressive Multifocal Leukoencephalopathy (PML), and many more.
- Diroximel Fumarate (Vumerity)
Vumerity is a capsule that needs to be taken twice a day, similar to Techfidera. Still, the exact mechanism of these oral pills is not known, but it may help to fight against the damage caused within CNS by lowering oxidating stress. Relapse forms might be treated by Vumerity. The common side effects of this drug include redness, flushing, itching, rash, nausea, diarrhea, vomiting, indigestion, or stomach pain. Even the side effects of this drug are similar to Techfidera, but it is much lighter on the stomach than Techfidera.
- Monomethyl Fumarate (Bafiertam)
Monomethyl Fumarate is also similar to Techfidera and should be taken twice a day. The side effects of this drug include diarrhea, flushing, abdominal pain, and nausea. Even the liver enzymes and blood count need to be observed.
- Zeposia (Ozanimod)
The mechanism of Zeposia is similar to Gilenya. It should be consumed once a day. Firstly, the doctor provides you with a low dose of these pills and increases it over a period of time. They don’t recommend these pills to patients with heart and liver issues. The common side effects are dizziness, respiratory infections, headaches, back pain, cold symptoms, and sometimes low blood pressure.
Drugs to Treat Fatigue
Fatigue is one of the most common symptoms of MS at almost every level. Thus, doctors prescribe a few medications to manage extreme tiredness. These medications include Symmetrel (amantadine), Nuvigil (armodafinil), Provigil (modafinil), and Ritalin (methylphenidate).
Drugs to Treat Pain
Neuropathic pain is a general pain and a symptom of Multiple Sclerosis. This pain needs the type of medication that directly targets overactivity in the nervous system. The most common medicines prescribed by doctors to manage this symptom are Anti-seizure drugs, such as Neurontin (gabapentin) and Lyrica (pregabalin). Certain antidepressants are also given to patients.
Other Alternative Treatments
Other alternative treatments are provided to the patients according to the severity and progression of their condition.
- Vitamin D
The levels of Vitamin D should be analyzed in the patient with MS. A sufficient level of Vitamin D in the blood is essential for the body suffering from MS. Those who have low levels are more likely to have MS, and they need to give a balance of Vitamin D to their body in order to reduce the risk of MS.
- Physical Therapy
A moderate level of exercise is necessary for the body. The patient with MS should contact a physical therapist to get the best recommendation of therapy and try to follow up on a regular basis. It will help deal with a lot of problems caused by the disease.
Experimental Treatments
Various therapies are rising to deal with MS with more research, though some experimental treatments like stem cell transplantation and estriol are controversial but could be beneficial.
- Estriol
An estrogen type produced in pregnant women, estriol, can reduce the risk of MS in the third trimester by 70%. It has been researched that it can lower pro-inflammatory cytokines. These are the inflammation-causing immune system cells that need to be reduced. The study shows that estriol with glatiramer acetate showed a promising result in women by reducing the rate of relapses.
- Stem Cell Transplantation
Stem cell transplantation has a significant value in patients with MS. It can help in building a new immune system that does not target myelin, according to the theory.
The study shows that no activity of MS was shown by 70% of patients after three years of stem cell transplantation. The MRI results showed no new lesions in cases that have undergone stem cell transplantation.
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