MS Active Source

Treatment

• Introduction
• Introduction to MS
• MS treatments
  • Intro to MS treatments
  • Interferons
  • Avonex
  • Betaferon
  • Rebif
  • Glatiramer acetate
  • Copaxone
  • Natalizumab
  • Tysabri
  • Treatment of relapses
  • Risk-sharing scheme
  • Progressive MS
• Positive approach
• Newly diagnosed?
• Relative with MS
• Links
• Principles of treatment

Medical Treatments for Multiple Sclerosis

Medical treatment options for MS fall into three main categories:

• Treatment for the underlying course of the disease.
• Treatment of the more progressive forms of MS.
• Treatment of relapses/exacerbations.
  

Treatment for the underlying course of MS is discussed below. Treatment for more progressive disease and relapses/exacerbations appears on other pages of this website (see the menu on the left).

A Pathway Through MS: Understanding and Treating your MS

This is a video programme that has been produced to help people with MS understand their condition and the treatments available. Separate sections of this programme appear on other pages of this website.

The section of the video on this page investigates the different types of disease-modifying treatments (DMTs) that are available for MS, those DMTs that can be self administered and the DMT that is infused. The video features interviews with specialists, giving up-to-date information on current treatments, as well as interviews with people with MS who describe their experience of being on a DMT.

Treatment Options

Points covered in this part of the video:

• Three types of DMTs are available for patients with MS: interferon beta, glatiramer acetate and natalizumab.
• DMTs act on elements of the immune system.
• All DMTs can reduce the relapse rate.
• Interferon beta treatments and natalizumab can slow the progression of physical disability.
• Injection type and frequency varies between treatments.
• Treatment with a DMT should be considered a long-term commitment.
  

Interferons

Interferons are proteins that help control (regulate) the immune system. They are naturally released by the body when inflammation occurs. One class of interferons, known as the beta interferons, has been shown to be effective in slowing down inflammation in MS, modifying the course of the disease (refT1).

There are two types of beta interferons available to treat MS: interferon beta-1a and interferon beta-1b. These agents help regulate, or modulate, the abnormal immune response seen in people with MS. Consequently, they are known as immunomodulatory agents or disease-modifying treatments (DMTs).

Role of Neutralising Antibodies

Antibodies are molecules that the body can make as part of its normal defence (the immune system) against foreign bodies, such as viruses. For example, when a person is infected with the 'flu', their body makes antibodies against the flu virus (this takes a few days) and eventually these antibodies help to defeat the virus.

When a person gets vaccinated against flu, the doctor is injecting an inactive form of the flu virus. The person’s body will then make antibodies against the injected virus and, when they are exposed to the natural or 'live' flu, they will already have an antibody defence established. That means they can defeat the virus before it makes them ill.

When people are treated with a protein such as interferon beta, the immune system may respond by generating antibodies. Some of these antibodies may interact with the protein to prevent it from having its normal effect. These are called neutralising antibodies. Therefore, people with MS receiving interferon beta therapy may develop neutralising antibodies.

These neutralising antibodies may interfere with the beneficial effects of treatment on relapses. The effects of neutralising antibodies on disability progression are not known at present.

It appears that neutralising antibodies occur to different degrees with different interferon beta drugs. What the clinical consequences of this may be is not yet fully understood.

Glatiramer acetate

Glatiramer acetate, like interferon beta, acts to reduce inflammation around nerves which usually preceeds a relapse. It consists of a 4-amino acid polypeptide which resembles the protein, myelin, found in the sheath surrounding nerves. Its exact mode of action is unknown. (refT3)

Glatiramer acetate has been shown to produce a comparable reduction in the risk of a relapse to that observed with interferon beta in patients with RRMS. (refT1)

Natalizumab

Natalizumab is a monoclonal antibody, a protein that is similar to your own antibodies. Natalizumab will stop the cells that cause inflamation from entering the brain, this helps reduce the nerve damage caused by MS.(refT4)

As with interferon beta neutralising antibodies can occur in some patients, this may mean natalizumab therapy has to be stopped. (refT4).

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