Can Multiple Sclerosis Be Cured?

MS is an autoimmune disorder where the body attacks itself. There is no cure for multiple sclerosis. The treatment approach is aimed at recovery of the patients from the MS attacks, delaying progression of the disease and managing the symptoms. People who have mild symptoms need not require any treatment. Here we list the possible medication options depending upon the attack and progression of the disease.

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Attacks Of Multiple Sclerosis:

Immune Suppressants. Corticosteroids are the drugs mostly prescribed for multiple sclerosis attacks. Corticosteroids produce effects similar to the adrenal gland hormones, which suppress the inflammation. Oral and intravenous methylprednisolone are widely prescribed. Corticosteroids have its own set of side-effects such as increased risk of infection as immune system will be compromised, insomnia, high blood pressure, mood swings and fluid retention.

Plasmapheresis. This procedure is adopted depending upon the severity of the disease and people who do not respond to steroids. In this procedure, the liquid part of the blood i.e. your plasma is removed and the blood components (red blood cells, white blood cells, platelets, etc are separated and removed. The fluid portion which contains the antibody is removed and replaced with the protein solution (albumin).

Disease Modification And Progression:

Primary-progressive MS. Ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy (DMT) for primary-progressive MS. Patients who are on Ocrevus are less likely to have a progressive form of the disease.

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Ocrelizumab (Ocrevus). It is used to treat both the relapse-remitting and primary-progressive forms of multiple sclerosis. It decreases the disability rate in both the disease forms. It is administered intravenously. The main side-effect of this medication is injection site reaction, low blood pressure, fever, and nausea. It also increases the risk of breast cancer.

Relapsing-Remitting MS. A number of disease-modifying therapies and relapsing-remitting treatment options are available. The immune system becomes aggressive during the initial stages of the disease and the introduction of diseases can decrease the relapse rate and slow the formation of new lesions. Most of the medications have their own set of side-effect profile and the medications are selected considering the risk factors, duration, and severity of the disease. The other factors which are to be considered for MS are cost, other co-morbid diseases, and the reproductive age.

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The treatment for relapsing-remitting multiple sclerosis include

Beta Interferons. This medicine is indicated to reduce the number of attacks and its severity. It can be injected subcutaneously or intramuscularly. The most important side-effect is the development of neutralizing antibodies against interferons decreasing the efficacy. The other side-effects include flu-like symptoms and injection-site reactions

Side effects of beta interferons may include flu-like symptoms, increased liver enzymes, liver damage, and injection-site reactions.

Glatiramer acetate (Copaxone, Glatopa). It blocks the immune system attack on myelin. Copaxone can be injected subcutaneously. Injection site reaction is the main side-effect of this medication.

Fingolimod (Gilenya). It is helpful in treating relapsing-remitting form of the disease. This orally administered drug decreases the heart rate and requires careful monitoring.

Natalizumab (Tysabri). This medication prevents the movement of harmful immune cells from the bloodstream to the brain and spinal cord. This is the first line treatment for people with severe multiple sclerosis. It increases the risk of progressive multifocal leukoencephalopathy (PML).

Alemtuzumab (Campath, Lemtrada). This drug acts on a protein on the surface of immune cells and decreasing white blood cells. This prevents potential nerve damage and increases the risk of infections and autoimmune disorders.

The other medications which can be used are Dimethyl fumarate (Tecfidera), Mitoxantrone and Teriflunomide (Aubagio).

Conclusion

There is no treatment for multiple sclerosis. Certain medications can be used to modify and slow the progression of the disease. Multiple sclerosis attacks can be controlled by the use of corticosteroids (methylprednisolone) or Plasmapheresis. Ocrelizumab (Ocrevus) is the only FDA approved medication which is useful for both the relapse-remitting and primary-progressive forms of multiple sclerosis. The relapsing and remitting form of MS can be treated with medications such as Beta interferons, Glatiramer acetate, Fingolimod, and Natalizumab. Each medicine has its side-effects; the medicine is prescribed considering the severity and the risk. benefit ratio.

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Sheetal DeCaria MD

Written, Edited or Reviewed By:

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Last Modified On: April 3, 2019

This article does not provide medical advice. See disclaimer

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