New Drug Treatments for Multiple Sclerosis

By:    Medically Reviewed: Tom Iarocci, MD   Published: June 26, 2014

New drug treatments are poised to change the way patients manage multiple sclerosis, and possibly other autoimmune diseases.

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Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system — the brain and spinal cord — and causes nerve damage and loss of function. It makes your own immune system attack myelin — the protective insulation surrounding your nerve fibers — as well as the nerves themselves.

When those nerves are damaged, it disrupts signals within the brain (and signals from the brain to the spinal cord) and causes a wide range of symptoms, including vision loss, cognitive difficulties, numbness and tingling, loss of balance and fatigue.

Treatments for MS depend on your symptoms and the course of your disease. MS can take on a progressive, steadily worsening course in some patients, which is often harder to treat than relapsing forms of MS.

 

Main Treatment Goals in MS

Most current therapies target one of three outcomes for MS: reducing the disease progression, managing relapses and treating symptoms. The medications currently approved to reduce progression of the disease all aim to suppress the immune system and decrease inflammation.

Controlling inflammation may reduce damage to the myelin sheath and to nerve fibers caused by MS.

The medical community hopes to soon find a way to improve and repair this nerve damage, rather than just slow it down, and it looks like this might be on track. “A treatment that is both anti-inflammatory and neuroprotective will give us much greater hope for halting progression and even causing repair and improvement,” says neurologist Rhonda Voskuhl, MD, director of the UCLA Multiple Sclerosis Program in Southern California. “That’s different from just slowing the decline; it’s actually trying to make things better.”

 

New MS Treatments

Until recently, patients had to administer the medications for treating MS themselves by injection, and most injections had to be done daily. In 2010 and then again in 2012, the Food & Drug Administration approved oral drugs for MS, and more options are on the market today. 

Tecfidera (dimethyl fumarate): Launched in 2013 to to treat MS, Tecfidera has had a high success rate. A new study in the medical journal “Immunity” suggests that new pharmaceuticals like this may help slow the progress of other autoimmune diseases, including psoriasis and rheumatoid arthritis. (Neither teriflunomide nor dimethyl fumarate is free of side effects, however, based on data from clinical trials.)

Estriol: It’s been known for a time that women’s MS symptoms improve significantly during pregnancy. A recent study giving women oral estriol, in combination with injections of Copaxone (glatiramer acetate), a current standard MS drug, found promising effects. “Within a year, we see significant improvements in cognitive testing and 47-percent reduction in MS relapses,” says Voskuhl.

Testosterone: Similar research is being done using testosterone for male MS patients. “This hormone is converted in the brain,” says Voskuhl, “and it may be neuroprotective and even halt brain atrophy.”

Myelin peptide patch: This approach tries to get the immune system to tolerate, rather than attack, the myelin proteins. A yearlong recent study using transdermal skin patches to administer myelin peptides found a 66-percent reduction in the cumulative number of brain lesions, compared to the placebo group. The relapse rate was also significantly lower than in the placebo group.

Stem cells: Clinical trials are currently being conducted to look at the potential of stem cells to treat MS. Adult stem cells are harvested from a patient’s own bone marrow and then injected into fluid surrounding the spinal cord. The therapy shows promise for reducing brain inflammation, repairing myelin and improving brain function.

 

Next Steps

If you have been diagnosed with MS, you could be eligible to participate in research to help treat, halt or — someday — cure the disease. Volunteering to take part in a study or clinical trial not only may benefit you, but also could open the door for improved treatment options for all who suffer from this condition.   

 

For Caregivers:

A person in the throes of MS needs a healthy and vital caregiver who can offer long-term physical care, as well as patience and ongoing emotional support, so caregivers should always remember to take care of yourselves, too. Visit the National Multiple Sclerosis Society to tap into additional family resources that may help everyone as the disease progresses.

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