Immunosuppressive drugs for the treatment of multiple sclerosis | Immunosuppressive drugs

Immunosuppressive drugs for the treatment of multiple sclerosis

Multiple sclerosis is an inflammatory, autoimmune nerve disease in the course of which the protective layer around the nerve fibers (myelin layer) is increasingly destroyed. MS progresses in phases, i.e. intervals of almost complete freedom from pain alternate with strong attacks of the disease. Especially during the disease attacks, high doses of methylprednisolone and prednisolone are used or, if necessary, plasmapheresis (washing out of the autoantibodies) is performed.

Very high doses (up to 1000 milligrams) are often administered intravenously at the beginning of an acute attack, after which the medication can be switched to tablets with lower doses. The basic therapy includes glatiramer acetate and interferon beta, in relapsing-remitting MS also dimethyl fumarate, in relapsing-remitting MS also dimethyl fumarate, in relapsing-progressive MS mitoxantrone. Mitoxantrone is a very strong immunosuppressive agent that leads to the destruction of B immune cells.

In relapsing-remitting MS, alemtuzumab (antibody against CD52, a surface protein on immune cells), fingolimod (reduces the migration of immune cells into the central nervous system) or natalizumab (antibody, reduces the migration of immune cells into the central nervous system) can also be used for escalation. Many of the immunosuppressants used in MS are very potent and can cause severe side effects. The most feared is Progessive Multifocal Leukenzephalopathy, which can occur under therapy with dimethylfumarate or Natalizumab. Side effects include fatigue, headaches, depression and hypersensitivity reactions to the drugs.