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Multiple Sclerosis Treatment

Patients from around world travel to the Wayne State University MS Center at Harper University Hospital for the latest MS treatments. Six drugs are currently approved by the FDA for the treatment of MS. These treatments can be viewed as treatments to alter course of disease.

Treatment of the Disease
The term “disease-modifying therapy” or DMT means a drug that can modify or change the course of a disease. In other words, a DMT should be able to reduce the number of MS attacks and also slow down the disease from progressing.

Currently, the following seven drugs have been approved by the FDA for the treatment of relapsing-remitting and relapsing forms of MS:

  • IFN beta-1b (Brand name Betaseron®)
  • IFN beta-1a (Brand name Avonex®)
  • IFN beta-1a (Brand name Rebif®)
  • IFN beta-1b (Brand name ExtaviaÒ)
  • Glatiramer acetate (Brand name Copaxone®)
  • Natalizumab (Brand name Tysabri®).
  • Mitoxantrone (Brand name NovantroneÒ) This is a chemotherapy drug also approved for progressive forms of MS, including progressive-relapsing and secondary progressive MS.

Other drugs used as off-label treatments for MS include cyclophosphamide, rituximab, azathioprine, cellcept, and IVIG. These drugs are also available at the MS Center.

It is likely that patients may benefit from early treatment. The majority of MS experts encourage early treatment once the diagnosis of RRMS is confirmed. There is significant data to support the benefit of early treatment in patients who have experienced just one attack of MS but have MRI evidence to support the likelihood of developing MS in the future.

Treatment of the Symptoms
Only one drug has been specifically approved by the FDA for the symptomatic treatment of MS. This drug is known as AmpyraÒ (Dalfampridine). It contains the chemical 4-Aminopyridine, which blocks potassium channels and improves conductance in the nerves. This may lead to improvement in symptoms such as walking, heat sensitivity, motor fatigue, and leg weakness that occurs after physical effort. This chemical in the commercial drug is also available through compounding pharmacies. For the past 20 years, the drug was compounded by pharmacists and used as an off-label symptomatic treatment for MS. The commercial drug is manufactured by a pharmaceutical company.

Additional treatments to help the symptoms of MS are also available. These symptoms commonly include:

  • Vision difficulties
  • Speaking and swallowing difficulties
  • Weakness
  • Numbness
  • Pain
  • Limb stiffness
  • Clumsiness
  • Tremors
  • Bladder, bowel and sexual dysfunction
  • Thinking and memory problems
  • Depression
  • Fatigue
  • Episodic symptoms

These symptoms may affect a patient’s functioning and well-being. Treatment of symptoms may improve quality of life and day-to-day functional ability. However, symptomatic treatments do not slow down the disease from progressing.

DMC’s Comprehensive Approach
A comprehensive diagnostic and treatment plan is offered by the MS Clinic that includes not only treatment strategies but physical and occupational therapy, rehabilitation, vocational training, neuropsychological testing specific for MS, counseling, and advice on medico-legal issues relating to disability.

Since all of the treatments for the relapsing–remitting type of MS require the use of injectable drugs, the MS Clinic staff teaches patients how to inject their own medications at home. For drugs that have to be given intravenously, the MS Clinic uses facilities at Harper University Hospital to administer these drugs.

In addition to the FDA-approved drugs, a number of other therapies are available including plasma pheresis and chemotherapy for more difficult or aggressive types of MS not responding to first-line therapies.

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