New hope in multiple sclerosis treatment

While we don't yet have a cure for MS, there's a lot of breakthrough research going on worldwide. The good news is that some medications are showing very promising results.

There are currently a number of medications approved for MS in Canada that are considered disease-modifying drugs: four kinds of interferon treatments (Avonex®, Betaseron®, Extavia®, and Rebif®), glatiramer acetate (Copaxone®), natalizumab (Tysabri®), alemtuzumab (Lemtrada®), dimethyl fumarate (Tecfidera™), teriflunomide (Aubagio®), and fingolimod (Gilenya®).

Researchers find that these medications help some people have fewer relapses and delay the progression of their MS, especially if it's diagnosed and treated early. Unfortunately, none of these treatments can prevent recurring symptoms, such as fatigue and numbness, and they can't treat primary progressive MS. Avonex® can also be used to delay the onset of MS in people who have had a single attack and have MRI scans showing damage consistent with MS.

A medication called Novantrone® (mitoxantrone), belonging to a class of drugs called antineoplastics that is normally used to treat certain forms of cancer, can be used as a second- or third-line drug for the treatment of relapsing-remitting, progressive relapsing, and secondary progressive MS.

If you're experiencing some discomfort from a relapse or attack, your doctor might prescribe steroids for a short-term treatment. They are not usually taken over a long period of time, however, because of their side effects.

Some medications that might help treat symptoms include:

  • baclofen or tizanidine for muscle spasticity (stiffness)
  • methylprednisolone or oral steroids (such as prednisone) for optic neuritis (inflammation of the optic nerve)
  • antidepressants for fatigue or depression
  • acetaminophen, ASA, or other painkillers

There isn't much available for chronic progressive MS, but medications that are being studied are primarily immunosuppressants or drugs used to treat illnesses such as arthritis and some cancers. Researchers have noticed that medications such as methotrexate, cyclophosphamide, cyclosporine, and mitoxantrone (as briefly discussed above) have some effect on the progression of MS symptoms.

Corticosteroids, cyclophosphamide, and mycophenolate (a medication used after transplants to suppress the immune system) have also been studied in combination with interferons as "add-on treatment." On the other hand, the side effects of immunosuppressants can be quite severe, so studies are continuing in this area.

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