There are few treatments efficacious for the Progressive Forms of Multiple Sclerosis (PPMS and SPMS).  Most of the current treatment consists of anti-inflammatory disease modifying drugs that attempt to re-educate an mistaken immune system. They attack the Relapsing-remitting form of MS

Here is a summary of the arsenal:

  • Interferons (all injected)
  • Interferon beta-1a ( Avonex and Rebif;
  • Iinterferon beta-1b (Betaseron, Betaferon).
  • Glatiramer acetate or Copaxone (Polypeptides)
  • Mitoxantrone        (immunosuppressant)
  • Natalizumab  (Tysabri)  a monoclonal antibody
  • Fingolimod (trade name Gilenya) is a sphingosine-1- phosphate receptor modulator (Oral)

Those drugs have a variable success against the progressive forms of Ms which are believed to be  less of an inflammation process, and more of a neuro-degenerative aspect.

Secondary Progressive MS usually is often (50%) an end form of RRMS, and the above drugs offer a more  limited slowing down of the process. However some stem cell treatments are attempted with some positive claims. [1]

At the brain blood barrier

Primary progressive form of MS never had flares.  Here there is no real treatment so far. This is why the news that a drug, Masitinib, is in enrolling patients for a phase III trial is quite welcome [3]. The Study is French and directed by Prof. Vermersch (CHRU Lille – Hôpital Roger Salengro, France)

What is puzzling about Masitinib  is that it also deal with inflammatory aspects of MS, widening the debate over the relative importance of inflammation versus neurodegeneration in Progressive MS.

The answer can be in the quote from BMC’ ‘s Neurology journal:

” [masitinib] induces a reduction in the number of lymphocytes infiltrating the brain….Masitinib has a  targeted inhibitory action on mast cells that can delay the onset of symptoms associated with progressive forms of multiple sclerosis.”

Note: Mast cells are present in most tissues characteristically surrounding blood vessels and nerves, and are especially prominent near the boundaries between the outside world and the internal milieu. They similar to the blood’s white cells [Wikipedia]

Delaying the onset is different from healing full blown Progressive MS

However, saying that  [3]:

“….Neuroinflammation is thought to be important in progressive multiple sclerosis pathogenesis… ” is controversial [4]

We shall see….

Talk to your Doctor

Sources:

  1. medinewsdigest ; ”Progress in Stem Cell Treatment of Secondary Progressive Multiple Sclerosis” ; Feb 2012
  2. bestpractice ; “Multiple Sclerosis” ; 2011
  3. BMC Neurology ; “”Masitinib treatment in patients with progressive multiple sclerosis: a randomized pilot study” ; 2012
  4. medinewsdigest ; “New Study shows Multiple Sclerosis caused primarily by inflammation, not neurodegeneration” ; Dec 2011
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