Whether you’ve just been diagnosed with multiple sclerosis or you’ve been dealing with your symptoms for years, it’s in your best interest to keep on top of the latest advances in medications. The good news is there are plenty of drugs being tested, and hopefully many will get through the regulatory pipeline to help patients cope with their MS.
But here’s the rub: Not every new medication you hear about is ready to be prescribed or is the right fit for your type of disease. “Some drugs may be years from getting approval, others may never make it, while still others may be getting a big boost in publicity when they first come on the market but aren’t going to help a particular patient — or there’s a better option already available with fewer risks and potential side effects,” explains Dr. James W. Stark at the International Multiple Sclerosis Management Practice in New York City.
[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]
And since MS is a complex disease, the right drug may not be a simple match. In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between the brain, spinal cord and the rest of the body. Eventually, the disease can cause the nerves to deteriorate or become permanently damaged, affecting different parts of the body, including vision, balance and cognitive issues.
Because patients differ in how their symptoms progress, there’s a lot to take into consideration, including the way drugs are administered. For example, some medications are delivered by injection (either by the patient or their caregiver), some are in pill form and others are given intravenously by a medical professional.
The latter is the case for Ocrevus, approved by the FDA in December 2016. Although it’s not a cure, it’s another option for some of the 400,000 people diagnosed with MS. “In trials of over 1,600 MS sufferers, Ocrevus cut nearly half the relapses in patients with the most common form of MS — Relapsing Remitting MS,” explains Dr. Fred D. Lublin, director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at the Ichan School of Medicine, Mount Sinai, and one of the participating researchers in the study that was published January 2017 in the New England Journal of Medicine.
“It was also effective in preventing relapse in patients with Primary Progressive MS. Until Ocrevus, no other drug proved to be effective in treating this form of MS,” Lublin says.
[See: 10 Lessons From Empowered Patients.]
That’s a hopeful development for the approximately 15 percent of people with MS diagnosed with this form of the disease. “PPMS is characterized by worsening neurologic function from the onset of symptoms without early relapses or remissions,” according to the National Multiple Sclerosis website.
Like all drugs, side effects have been reported with Ocrevus. “There can be flushing around the infusion area, an increased risk of infection, as well as a slightly higher risk of breast cancer,” Lublin says. “About one half of 1 percent of the patients who took the drug developed breast cancer, which is twice the rate of those who did not take the drug.”
Ocrevus also needs to be administered intravenously every six months, and it takes around five hours to complete the treatment. A 2015 study published in the International Journal of MS Care that looked at RRMS patients’ preferences in treatment therapies found that most preferred a daily oral pill instead of injection or infusion.
Gilenya is a pill approved by the FDA in 2010 to treat RRMS. “This medication can also decrease the number of episodes of worsening symptoms and may prevent or delay disability by stopping immune system cells (lymphocytes) from attacking the nerves in the brain and spinal cord,” Stark explains. “There are newer versions of this drug in the pipeline that may be better tolerated (common side effects are headache, abnormal liver tests, diarrhea, cough, flu and sinusitis) and are more effective, but they’re still in trial.”
A cutting-edge treatment that’s also still in trial involves stem cell repair with cells taken from the patient, not from an embryo, so there are no ethical issues. The New York-based MS management practice has completed Phase I of the study. “We were able to show improvement in lower extremity function as well as bladder and bowel function in some patients who had long-standing disabilities,” Stark says. “The FDA has approved us for a Phase II study which will look at whether stem cell treatment can help patients with chronic progressive MS symptoms.”
[See: 5 Rare Diseases You’ve Never Heard of (Until Now).]
There’s also hope for longer-lasting relief of muscle spasticity — a common symptom of MS. Baclofen is a pill routinely prescribed for this problem, but it only lasts around four hours and has side effects that include drowsiness, dizziness, weakness, headache, trouble sleeping, nausea and increased urination or constipation. “There’s research into a new version that lasts up to 12 hours and has fewer side effects,” Stark says.
Perhaps even more appealing to some is Sativex, a cannabis-based solution supplied in small vials as a spray that the patient directs under the tongue or inside the cheeks to treat MS spasticity. It’s made from the extract of the cannabis sativa plant that contains the principal cannabinoids THC and CBD, as well as other non-cannabinoid components. The drug is already licensed for MS spasticity in 16 countries outside the U.S., including Canada and countries throughout Europe. It won’t get patients high, but a 2011 study published in the European Journal of Neurology showed that Sativex is effective as an add-on therapy to treat symptoms of moderate or severe spasticity in people with multiple sclerosis who are not responding to other anti-spastic treatments.
“Whatever symptoms MS patients are dealing with, the important message is to stay in touch with your doctors,” Stark says. “They should know which promising medications are in the pipeline if you might be a good candidate for a new drug trial, and if a drug has recently been put on the market and it’s right for you.”
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What’s the Latest in the Pipeline for MS Drugs That Might Help? originally appeared on usnews.com
