Multiple sclerosis – new treatment options ahead | Grand Harbour Medical Clinic, Cayman Islands

Multiple sclerosis is a feared disease. It usually affects otherwise well young people often in the prime of their productive lives. Multiple sclerosis is characterised by episodes of inflammation in the central nervous system. Each episode lasts for several days to weeks and can affect any part of the body. Sometimes it is possible to get only one episode and then no more, but if there are two separate episodes spaced over months or years and usually affecting separate parts of the body then that suggests a diagnosis of multiple sclerosis. Each episode can resolve so there is little or no residual loss of function, but damage remains to the nervous system. Over a period of time each episode adds up to substantial disability in terms of walking or using limbs or seeing.

In the last decade there are treatments that are given by injection and that appear to make a substantial benefit especially if started early after the diagnosis is made. This for an individual patient has had the effect of slowly the disease down.

It is also of interest that multiple sclerosis is one of those disease that is more common in high latitudes than in equatorial areas suggesting there may be a link to inadequate levels of vitamin D. This suggests avenues of research for the possibility of prevention and other treatments in the future. Certainly it seems sensible to ensure that patients with a single episode or have multiple sclerosis are not vitamin D deficient.

In the last week there have been published studies using two new and different treatments for multiple sclerosis that appear to show much improved effectiveness compared to some present treatments. Using these oral treatments the relapse rate each year was around 20 % compared to around 40% on one study comparing the treatment to placebo ( no treatment) and 33% comparing to one of the presently available treatments – weekly injections of interferon beta 1a. This shows considerable improvement.

All these new treatments alter the immune system and so there are potential effects of sometimes life-threatening viral infections and the ever present concern as to an increase in cancer rates. however I am sure that these treatments will become part of a variety of these increasingly effective treatments for this once untreatable disease.

It should provide additional comfort to those with the diagnosis and hearten those involved in the research and caring for patients with this sometimes severely disabling disease.

Link to one of the multiple sclerosis studies

Link to the UK multiple sclerosis society