We still do not have a treatment to cure multiple sclerosis, although in recent years the approval of new drugs has produced a substantial change in their approach. The therapies available are aimed at modifying the evolution of the disease and alleviating its symptoms. We show you the pharmacological treatments available.
Disease modifying treatments
To reduce the frequency and severity of flare-ups, decrease brain damage, and delay the increase in disability are disease-modifying treatments (DMTs).
These treatments do not relieve symptoms, but they do manage to modify the course of the disease. These drugs have been found to be most effective the sooner they are started, after diagnosis, and before MS has caused significant harm.
Disease-modifying treatments can also have adverse effects such as risk of infections among others. Thus, it is essential that people with MS have enough time to learn about these treatments. Person-centered decision making has been shown to improve adherence to treatment.
Treatment is generally started with first-line drugs, such as interferon beta and glatiramer acetate, which reduce the rate of outbreaks and new lesions. These TMEs act on different aspects of the immune system without causing immunosuppression, so they are generally quite safe. If the expected response does not occur, then the neurologist usually prescribes one of the second-line drugs, such as natalizumab and fingolimod, which are more effective, but can have certain adverse effects.
On the other hand, to maintain functionality in daily life, there is rehabilitation treatment, which is complementary and just as necessary as disease-modifying treatments. Its objective is to improve the course of acute episodes and to treat symptoms.
It is a multidisciplinary treatment, which includes, in addition to pharmacological treatment, physiotherapy services, cognitive stimulation or adequate nutrition. The drugs that treat these symptoms are included within the term “symptomatic treatments” and although they do not modify the course of the disease, they improve the quality of life of people with MS. Since the symptoms can be very varied, the best option is to consult the neurologist each time a new symptom appears.
Treatment of flare-ups
When a person with MS has a severely affected outbreak, the neurologist usually suggests treatment with corticosteroids, a type of anti-inflammatory that does not improve recovery from the outbreak in the long term, but can reduce its duration and severity. Although they can be prescribed orally, the most common form of administration is intravenous for about 3-5 days. This treatment is usually well tolerated, but the possible side effects it can cause should be known and taken into account.
Research in EM continues. The main lines of research focus on myelin deficiency, immune system dysfunction and neurodegeneration.
An up-to-date list of publicly funded clinical trials from around the world can be found in the ClinicalTrials.gov database.
The development of new drugs represents a direct improvement in the quality of life and an injection of hope for the future of many people.