Available treatment options
Multiple sclerosis is an autoimmune disease wherein the immune system attacks the protective layer of the brain cells and spinal cord. This layer, known as the myelin sheath, also speeds up impulse transmission from the brain to the rest of the body.
Like other autoimmune diseases, the treatment aims to suppress the immune response and slow down damage. There are many symptoms of MS, some of which include fatigue, weakness, tremors, hearing loss, bladder dysfunction, and breathing problems.
Multiple sclerosis can be relapsing-remitting, progressive, or progressive-remitting. Remitting means that symptoms go away, while relapsing means the symptoms come back. Progression means that the disease symptoms get worse over time. Treatment depends on the diagnosis. Because MS is a chronic disease, treatment is long-term, oftentimes lifelong.
Medications for MS treatment and interventions
Treatment of acute attacks
Glucocorticosteroids treat the initial attack or short exacerbations. Exacerbation happens when a patient encounters a trigger or stress that worsens symptoms. Steroids work by suppressing the immune system response which reduces the severity and duration of the attack.
Examples of corticosteroids used in MS are methylprednisolone, dexamethasone, and prednisone. One treatment approach is to give patients 500mg to 1g of intravenous methylprednisolone per day for 3 to 5 days. This may be followed-up with tapering doses of oral prednisone starting at 60 to 80 mg per day, and gradually reduced over 2 weeks.
Steroid treatment of acute attacks in MS treatment and interventions is generally short-term. Prolonged use of steroids can cause unwanted side effects such as decreased immunity, water-retention, weight gain, and osteoporosis.
Disease-modifying drugs (DMDs) are mainly used in patients with relapsing forms of MS. In some cases, DMDs can be used to treat SPMS. This is due to overlapping symptoms.
Examples of DMDs are interferon-β, glatiramer acetate, monoclonal antibodies, and fingolimod. These drugs have different mechanisms but all work by altering the response of the immune system. Some of the cells in the immune system that are targeted by these drugs include T cells, APCs, and macrophages.