I have noticed a trend in our monthly MS Town Hall Meetings: Despite (or maybe because of) the potential risks involved with the newer medicines, people want to talk about symptom management and not necessarily the fancy new disease modifying agents.
Those of you who have read previous blogs know that there are three arms of MS treatment:
1. Disease modifying agents -- to try to change the course of MS in the individual person.
2. Symptomatic treatment -- to try to manage various symptoms and make you feel better. This does not necessarily mean medicines -- it can range from breathing exercises to yoga to complementary and alternative medicine (CAM).
3. Rescue treatment -- These are used when things are getting bad -- the most common is IV Solumedrol.
Let's look at each of these separately:
1. These include the 4 injectable medicines (Avonex, Betaseron and Rebif) and the IV medicine into the vein (Tysabri). Sometimes we use chemotherapies and other medicines. Most of the newer research is with newer types of medicines like oral medicines and IV medicines.
These newer medicines, unlike the older ones; may be risky. So why is research going into them? There are two main reasons: We are trying to make more effective medicines and we are trying to make medicines which are more convenient and tolerable.
2. There is also a medicine being developed to help make nerves work better. This medicine (called 4-Aminopyridine or Fampridine) has been shown to speed up walking time and help other symptoms, like fatigue. At the University of Florida Jacksonville, we will be starting a trial of an Ashwagandha (an Ayurvedic or Indian) herb for the treatment of MS related fatigue. Please email firstname.lastname@example.org if you are interested (for now the trial will only be in Jacksonville, FL).
3. If you are receiving steroids too often, then this may mean that the medicine listed under "1" above might not be strong enough for you. Besides steroids, we sometimes use IVIg or plasmapheresis (plasma exchange or cleaning out the blood).
So now that you know what you neurologist is thinking about, it can help you remain the center of the MS team and better structure your office visit. Please remember to speak with your personal physician regarding symptoms and treatment options.
Published On: September 11, 2008