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Therapies for Multiple Sclerosis

Disease-Modifying Treatments

Despite the great strides we have made in understanding MS, there is still no cure for the disease. But treatments are available. Some of these treatments have been shown to reduce relapses - some of them also slow the progression of disability in the relapsing type of MS. For this reason, these treatments are known as disease-modifying treatments, they include interferon beta, natalizumab and glatiramer acetate can be grouped as:

• DMTs that are self administered i.e. interferon beta and glatiramer acetate.
• DMTs that are administered by infusion i.e. natalizumab.

Other treatments for MS include corticosteroids, used to treat attacks/relapses.

More details on treatments can be found by following this link.

Staying on Therapy

MS therapies aim to slow down progression of the disease and delay the rate of damage to the CNS; they do not repair damage that has already been done. In MS, permanent damage can occur in the early stages of the disease and, once this has happened, it cannot be reversed. So, as soon as possible after diagnosis, a person with MS should start on treatment. Starting on treatment early and staying on it is the best way to control the disease.

During times when people are not having symptoms, it is still important to remain on the treatment. Research shows that MS continues to progress even when a person is not experiencing relapses. This ‘invisible aspect’ of MS involves ongoing CNS inflammation, permanent scarring and loss of brain and/or spinal cord tissue, which means a persons MS may still be progressing even when they don't have symptoms.

Some people may experience side-effects from treatment or feel anxious about being injected with a needle (most currently available DMTs are injected). It is natural to feel discouraged about your treatment at times. It may help to remember that in most cases the long-term benefits of slowing the progression of disability far outweigh any short-term discomfort you may be feeling. Any discomfort may eventually go away. If problems persist, the MS nurse specialist or neurologist can provide advice and sources of support.

Success of Therapy

Since MS is so unpredictable, no two people will have the same course of illness or the same symptoms. One thing that nearly all people with MS have in common is  attacks/relapses, the outward effects that can be disruptive to your daily life. Although medical researchers are trying to unlock the mystery of MS, currently no cure exists.

But, a proven treatment programme can take some of the unpredictability out of life with MS. Unfortunately, until there is a cure, occasional relapses may well still be a part of life with the disease.

When relapses occur, it is natural to question how well your therapy is working. No current therapy can completely eliminate relapses. But by starting therapy early and staying on it, you can expect to reduce the number of relapses you may experience.

Availability of DMTs: The Risk-Sharing Scheme (ref L2)

A study into the cost-effectiveness of disease-modifying treatments (DMTs) for MS (Avonex, Betaferon, Copaxone, Rebif) is currently ongoing in the UK (refT11). The study is organised by groups including the NHS, many other government departments, specialist nurse associations, neurologists and MS societies. People with RRMS or secondary progressive MS where relapses are dominant will be monitored and treated. All persons enrolled in the study must meet the criteria specified in the Association of British Neurologists guidelines, as discussed in other parts of the Treatment section.

The study is known as the risk-sharing scheme, but the risk is not to the MS patient. Instead, the risk is a financial one that will be shared by the pharmaceutical companies who make the DMTs. The risk is that the DMTs will not meet a cost -effectiveness target in the long term, and if this is the case it is agreed that the NHS will pay less for the drugs (refT12).

More information can be found by going to www.mstrust.org.uk. Please be advised that we are not responsible for the content of external sites. Please read our legal disclaimer.

Interferon Beta and Neutralising Antibodies

Antibodies are molecules that the body makes 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.

Neutralising antibodies are a type of antibody that ‘neutralises’ the activity of a molecule that the body thinks is foreign. They can be active against medications made from proteins, such as interferons. So, theoretically, a person could develop neutralising antibodies against an interferon beta medication.

If the body makes neutralising antibodies against the drug a person is taking, then the drug may be prevented from reaching its target. With some drugs, neutralising anitbodies can reduce their effect. But the clinical significance of neutralising antibodies to interferons in MS is unknown.

There are many factors that can impact on the development of neutralising antibodies i.e. how the drug is administered, the dose and dose frequency.

There is no way to know if a person has developed neutralising antibodies unless they are tested. For people with concerns about neutralising antibodies or who would like more information, your MS nurse specialist or neurologist can discuss this subject in more detail.

Please click here to download a leaflet on NABs.

Complementary Therapies

Some people with MS find the use of complementary or alternative therapies to be helpful. There are a growing number of such treatments, including:

• Special diets.
• Acupuncture.
• Reflexology and massage.
• Fish oils.
• Magnetic field therapy.
• Neural therapy.
• Massage plus body work.
• Multimodal therapy.
• Hyperbaric oxygen therapy.

There is no doubt that many of these therapies may help people feel better, and there may be no harm in trying them out, but please remember that no alternative therapy has shown convincing evidence that it can actually improve MS. Also, while one treatment might work well with a therapy that the doctor or health care professional has prescribed, another could interfere with the effects of regular therapy.

It is advisable to carefully evaluate the cost, likely benefits and potential risks of the treatment. It's also important to keep your MS nurse specialist and/or neurologist fully informed of any complementary treatments you are taking or thinking of taking.

If you are interested in complementary medicine, one sensible approach is to find out more by contacting a professional body or accredited practitioner with expertise in the area. A good place to start might be:

• Selfhelp, the website for people with MS by people with MS 

Please be advised that we are not responsible for the content of external sites. Please read ourlegal disclaimer.

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