Drugs | Therapy of multiple sclerosis

Drugs

Multiple sclerosis is not curable. The aim of the therapy is to relieve the symptoms and slow down the further progression of the disease. It is important to treat acute relapses in the short term and to alleviate the symptoms.

This is achieved with cortisone preparations, which are administered in high doses. This inhibits the inflammation so that the symptoms disappear as quickly as possible. In addition, long-term therapy is necessary.

Since multiple sclerosis is an autoimmune disease, the treatment consists of positively influencing the immune system. This form of therapy is called immune modulation and various drugs can be used. Drug therapy should be started early, as damage to the nervous system occurs in the early stages of the disease.

Interferon is a natural messenger substance in the human body. It is responsible for transmitting information between cells. This is exploited in treatment with interferon.

It is thus possible to reduce the number of inflammatory cells. In addition, these cells are prevented from entering the blood vessels and thus from reaching the brain. This can prevent inflammation in the brain and slow down the breakdown of the nerve-isolating myelin sheaths.This is intended to reduce the frequency of MS relapses and minimize the impact of the damage.

For the therapy of multiple sclerosis, so-called interferon beta preparations are used. These are injected under the skin or into the muscles. At the beginning of interferon treatment, flu-like symptoms such as fever, chills and muscle pain often occur as side effects.

However, these usually subside after the first few months of treatment. For prevention, anti-inflammatory drugs such as ibuprofen or paracetamol can be taken in consultation with the treating physician. In addition, redness at the injection site, an increase in liver values, a decrease in white blood cells and depression and insomnia may occur during the course of therapy.

An increased risk of miscarriage exists for pregnant women within the first 28 weeks. In some cases, the body produces antibodies against interferon. This can impair the effect of the drug.

The antibodies can be detected in a blood test. Treatment with the drug glatiramer acetate (Copaxone®) is an alternative to interferon therapy. The time between two attacks is prolonged and the effects of the disease are alleviated.

The exact mechanism of action is still unclear, but it is believed that glatiramer acetate (Copaxone®) reduces the number of certain harmful cells. The drug is injected under the skin just like interferon beta. However, flu-like side effects occur in significantly fewer cases.

The most common side effect of treatment with glatiramer acetate (Copaxone®) is a skin reaction at the injection site. In addition, chest pain, reddening of the face, sweating, shortness of breath and a drop in blood pressure may occur. Fumarate (Tecfidera®) is another drug that is used for the long-term treatment of multiple sclerosis.

It is used in the form of dimethylfumarate (Tecfidera®) and, unlike the other two basic drugs, is taken orally in the form of tablets. Fumarate (Tecfidera®) has an anti-inflammatory effect on the one hand and protects healthy nerve cells by inactivating cell-damaging substances on the other. This reduces both the number of MS relapses and the extent of brain damage.

At the beginning of treatment with fumarate, gastrointestinal complaints often occur, but these should subside within a few weeks. In some cases, however, this side effect may be so severe that therapy with Tecfidera is discontinued. Furthermore, flushing occurs under Tecfidera.

This is a harmless but unpleasant sudden reddening of the skin. Usually a flush starts in the face and then spreads slowly over the entire body. The affected person has an unpleasant sensation of heat and burning on the skin.

Here too, the severity of the symptoms varies greatly from person to person. The frequency of flushes also varies from case to case. The blood count should be checked regularly to be able to detect a possible infection at an early stage.