Multiple Sclerosis (MS)
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Can MS be Treated?
There is as yet no cure for Multiple Sclerosis (MS). Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. Naturally occurring or spontaneous remissions make it difficult to determine therapeutic effects of experimental treatments - however, the emerging evidence that MRIs can chart the development of lesions is already helping scientists evaluate new therapies.
In the past, the principal medications physicians used to treat Multiple Sclerosis (MS) were steroids possessing anti-inflammatory properties - these include:
- Adrenocorticotropic Hormone (better known as ACTH)
- Prednisone
- Prednisolone
- Methylprednisolone
- Betamethasone
- Dexamethasone
Studies suggest that intravenous methylprednisolone (a corticosteroid hormone replacement drug medication) may be superior to the more traditional intravenous ACTH (adrenocorticotrophin hormone) for patients experiencing acute relapses - no strong evidence exists to support the use of these drugs to treat progressive forms of Multiple Sclerosis (MS). Also, there is some indication that steroids may be more appropriate for people with movement, rather than sensory, symptoms.
While steroids do not affect the course of Multiple Sclerosis (MS) over time, they can reduce the duration and severity of attacks in some patients. The mechanism behind this effect is not known - one study suggests the medications work by restoring the effectiveness of the blood/brain barrier. Because steroids can produce numerous adverse side effects (acne, weight gain, seizures, psychosis), they are not recommended for long term use.
One of the most promising Multiple Sclerosis (MS) research areas involves naturally occurring antiviral proteins known as interferons. Three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting Multiple Sclerosis (MS). Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, MRI scans suggest that beta interferon can decrease myelin destruction.
Investigators speculate that the effects of beta interferon may be due to the drug's ability to correct an MS-related deficiency of certain white blood cells that suppress the immune system and / or its ability to inhibit gamma interferon, a substance believed to be involved in Multiple Sclerosis (MS) attacks. Alpha interferon is also being studied as a possible treatment for Multiple Sclerosis (MS). Common side effects of interferons include:
- Fever
- Chills
- Sweating
- Muscle aches
- Fatigue
- Depression
- Injection site reactions
Scientists continue their extensive efforts to create new and better therapies for Multiple Sclerosis (MS). Goals of therapy are threefold: to improve recovery from attacks, to prevent or lessen the number of relapses, and to halt disease progression. Some therapies currently under investigation are discussed below.
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References:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke (NINDS)
National Institutes of Health
January 23, 2008
www.ninds.nih.gov/disorders/multiple_sclerosis/detail_multiple_sclerosis.htm
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