Currently MS cannot be cured, but new drugs are
providing patients with measurable benefits. In treating MS, a
major goal is to halt the immune response and stop demyelination.
While no drug developed so far has completely achieved this goal,
two new drugs show particular promise in slowing these processes.
These are Interferon beta (Avonex or Betaseron) and Copolymer 1
works against MS by down-regulating the
immune response. Interferon beta has been shown to decrease the
relapse rate in RR MS, decrease the number of active and new CNS
lesions, delay the progression and reduce the disability of the
works against MS by interfering with the T
cells that attack myelin, thereby suppressing the immune response
against myelin. Copolymer 1 has also been shown to decrease the
relapse rate in RR MS and reduce the disability. Patients may
experience side effects from these drugs, however the side effects
are usually manageable and may decrease over time. Both drugs are
available for use in the treatment of MS and are currently used
separately, not together.
A number of medications are also available that
can provide patients with some relief from the symptoms of MS, even
though they may not necessarily address the causes of MS or slow
the progression of the disease. These medications include drugs for
treatment of fatigue, pain, spasticity, tremors, bladder urgency,
constipation and other symptoms, and antidepressants. Because of
the variable course and severity of MS, not all medications will be
appropriate for every patient. When deciding which medications
might be helpful, patients should consult with their physicians to
develop a treatment plan based on their individual needs.
Despite the improvements that have been made in
managing MS, research continues on a number of other potential
approaches for treating MS. Two approaches, vaccination and oral
administration of antigens to induce immune tolerance, show early
promise. The potential of these approaches lies in the hope that
the immune response to the central nervous system can be
interrupted by selectively destroying or suppressing the self
reactive T cells.
In developing a vaccine against MS, the basic idea is that self
reactive T cells, or some component of them, might be able to
stimulate an immune response against these harmful T cells,
destroying them before they can damage the central nervous system.
In theory, if the self reactive T cells can be stopped before they
can damage the central nervous system, the progression of MS might
be halted. Experiments conducted in animal models for MS have shown
that animals can be vaccinated to induce an immune response against
the T cells that lead the attack on the central nervous system.
Clinical trials in humans have shown some success in generating an
immune response to self reactive T cells, but further research will
be required to determine if these methods will be useful in
altering the course of MS and if the vaccines can do so without
resulting in damaging side effects.
To induce immune system tolerance to the central nervous system
in patients with MS, researchers are studying the effectiveness of
orally delivered myelin or myelin associated proteins in
suppressing the immune system's reaction to the central nervous
system. Experiments in animal models for MS have shown that the
oral administration of central nervous system antigens such as
myelin can induce immune system tolerance, thereby stopping the
reaction against the central nervous system. Early clinical trials
in MS patients have shown promising results, but further studies
will be necessary to demonstrate the utility, effectiveness and
safety of this approach.