disease-modifying drugs

MS Relapse Management: A HealthCentral Explainer

CRegal Editor November 14, 2012
  • Sometimes it matters most to just have options.

     

    Prior to 1993, there were no disease-modifying drugs for multiple sclerosis.  In those days, patients could take steroids for relapses, but had no medications that could help change the course of the disease and control relapses before they occurred. 

     

    Among the first wave of drugs to hit the market were those in the interferon beta class, which includes drugs Betaseron, Avonex and Rebif.  With these drugs to complement steroid infusions for relapses, MS patients were able to finally get control of condition that had plagued so many for so long. 

     

    Then in 2012, a ground-breaking study found that drugs in the interferon beta class were ineffective in slowing the progression of MS.  Though the drugs were effective forsome people, there was little evidence to suggest that they were able to prevent or delay long-term disability. 

     

    The news was like a punch to the gut to many MS patients, especially those who took drugs in this class.  For nearly two decades, many people relied on this class of drugs and now they were being told that it may have all been a waste of time and money.

     

    [SLIDESHOW: 8 MS Treatments and Their Side Effects]


    However, there is hope.  In September, the Food and Drug Administration approved Aubagio (teriflunomide) for the treatment of relapsing-remitting MS.  This is a once-daily oral drug said to reduce relapses by up to 30 percent compared to patients  taking a placebo.  Though not as effective as Gilenya or Tysabri (other products by manufacturer Novartis), the side effects appear to be less severe and the drug may work for some where other drugs have been ineffective.  

     

    In addition to Aubagio, scientists have found that cancer drug alemtuzumab (Campath) reduces relapses, according to two new studies produced by the University of Cambridge.  The study compared alemtuzumab, normally administered to patients with leukemia or other cancers of the immune system, and interferon beta 1a.  The research concluded that patients who took the cancer drug had a relapse rate of 22 percent as opposed to 40 percent for interferon beta 1a patients.  Though the drug has been used off-label for some time, the results are encouraging because they provide clinical evidence.  

     

    New research in the field may also provide hope for the management of relapses.  According to two new studies published in the New England Journal of Medicine, a new drug may reduce relapses and disability progression in cases of RRMS.  An oral drug, BG-12 (dimethyl fumarate) is currently in two Phase III trials.  The studies found that the drug resulted in meaningful reductions in both relapse rate and brain lesions when administered twice or three times daily.  Those who took the drug saw a 50 percent reduction in relapses over those who were given a placebo.

     

    [QUIZ: Relapsing-Remitting MS: Symptoms and Relapses]


    Scientists have also recently uncovered what may cause some relapses: infertility treatments.  In a study from Argentina published in Annals of Neurology, researchers have found that reproductive hormones used to treat infertility could contribute to flares in autoimmune diseases, including MS.  Though the study  observed only 16 MS patients, 75 percent of the subjects experienced an exacerbation after the treatment.  The treatment was also associated with a seven-fold increase in relapse and a nine-fold increase in "greater MS activity."  The authors found that 73 percent of exacerbations were new symptoms and 27 percent  were worsening pre-existing symptoms, providing hope that avoiding infertility treatments could reduce relapses. 

  •  

    Twenty years ago, there were very few options for MS patients.  Today, there are seven disease-modifying drugs and others are being tested in clinical trials.  Numerous other medications exist for the management of symptoms or to prevent brain shrinkage.  The field has grown exponentially in this time and, as research and understanding of the disease increases, the future looks brighter for MS patients.

     

    Sources:


    n.p. (2012, September 15). "Aubagio (teriflunomide) Approved For Multiple Sclerosis Treatment, FDA." Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/250293.php.

     

    n.p. (2012, September 20). "MS Pill Shows Promise In Reducing Relapses." Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/250492.php.

     

    n.p. (2012, October 3). "Infertility Treatments May Significantly Increase Multiple Sclerosis Activity." Medical News Today. Retrieved from http://www.medicalnewstoday.com/releases/251005.php.

     

    Predit, Robert.  (2012, November 1).  "Cancer Drug Reduced Relapses in MS Patients: Studies."  MedlinePlus.  Retrieved from http://www.nlm.nih.gov/medlineplus/news/fullstory_130900.html