Treatment of multiple sclerosis is the most dynamically developing part of therapy in neurology. A significant change in the treatment of MS in the world in 2016 is a noticeable change in views regarding therapy. Separation of therapy can be clearly observed for patients with an aggressive form and for patients with a moderately active form. Modern drugs inhibit the process of loss of fitness and slow down the development of the disease, giving patients a chance for normal functioning. How to treat multiple sclerosis?
Treatment of relapses [may also be considered as symptomatic treatment].
It mainly concerns patients with relapsing-remitting MS. The condition for this type of treatment is diagnosis. The EDSS (Expanded Disability Status Scale) scale evaluates malfunction in MS. It enables credible comparison of patients’ condition, assessment of disease progression and, consequently, facilitates making appropriate therapeutic decisions.
On this scale we have a score from 0 to 10. Zero means normal mobility, and 10 means death.
Symptomatic treatment often does not differ significantly from the management of a cause other than MS.
The most common symptoms reported by patients include: spasmodicity, tremor, pain, mood disorder (depression), chronic fatigue, lower urinary tract disorder, and sexual dysfunction.
Treatment options for MS
In the treatment of multiple sclerosis, therapeutic goals may vary depending on the patient’s condition. The relapses and symptoms of MS are “treated” and the process of its development modified. We can distinguish immunomodulatory drugs – changing the natural course of the disease by reducing the number of relapses and their severity, and immunosuppressive drugs – affecting the immune system, less safe, but often more effective. Drugs for controlling specific symptoms and useful during relapse are also used to stop the inflammatory process that destroys the central nervous system.
Initially, the main challenge was to reduce the frequency of relapses and reduce symptoms. When this was achieved, methods of suppressing disease activity were sought, which is often already possible. Currently, there is a struggle to undo the existing changes in the nervous system.
Immunosuppressive drugs whose effectiveness is not fully proven in the treatment of multiple sclerosis (few clinical trials, significant cytotoxicity) are mostly so-called emergency therapy with a significant deterioration of the patient’s condition have a “suppressing” the immune system.
For patients with a primary progressive form, it has not been possible to find a drug that would (in a proven way) affect the general and neurological condition of the patients. In the current situation, symptomatic treatment is used in this group of patients.
In the many years of attempts to find effective therapy for MS, many preparations have been used, whose effectiveness proved to be more or less important for the course of the disease.