We will start with a status on the Disease-Modifying Therapies (DMT) study for Current Treatments Options Neurology
Quoting: “In a newly diagnosed patient with relapsing disease, the current practice is to start one of the interferons (interferon-beta) or glatiramer acetate”
First-line agent in relapsing-remitting MS :
Fingolimod : Oral drug; Increasing experience and if there are no new safety concerns
BG-12 : An oral medication; good safety and efficacy profile, while tolerably would need to be considered.
Under immediate consideration by FDA:
Teriflunomide : oral agent , pregnancy concerns
For refractory MS cases:
Natalizumab: A humanized monoclonal antibody, administered in infusions every 28 days; very small risk (30 cases known) of Progressive Multifocal Leukoencephalopathy, a usually fatal brain disease (Wikipedia)
Alemtuzumab in the near future, but Its efficacy would have to be weighed carefully against its safety profile. Alemtuzumab is currently used against cancer
Personalized medicine and Risk Strategies: Perhaps the most important development. Through advances in genetics and biomarkers and Risk strategies such as serum JC virus (John Cunningham brain Virus) antibody status and pre-determination an individual’s risk of autoimmune disease.
This steady progress are primarily for drugs designed against Relapsing Remitting MS (RRMS), but what about Secondary Progressive MS (SPMS) and Primary Progressive MS?
We published [2,3] posts on progressive MS, the field of treatments is definitely more narrow, which is striking since 50% of the RRMS will evolve into SPMS. Another reason for aggressive early treatment for RRMS: Get it treated while you have most of the weapons.
Which leads us to think the RRMS is the inflammatory start of MS. The Multiple sclerosis Trust agrees , quoting:
“…The majority of DMTs target inflammation; therefore they are of less relevance in primary progressive MS and have generally been shown to have a lack of efficacy…”
Talk to your Doctor
- Current Treatments Options Neurology ; “Emerging Disease-Modifying Therapies in Multiple Sclerosis” ;March 2012
- medinewsdigest ; “Progress in Stem Cell Treatment of Secondary Progressive Multiple Sclerosis” ; Feb 2012
- medinewsdigest ; “Perspectives on Primary Progressive Multiple Sclerosis” ; March 2011
- Multiple Sclerosis Trust ; “Primary progressive MS exposed: Past and current trials” ; 2011