After decades of research, multiple sclerosis patients are seeing a "rapid expansion" of effective new treatment options, according to a review article in the journal Neurologic Clinics.
Recently approved drugs, as well as medications being tested in clinical trials, appear to be more effective than the first generation of new drugs introduced in the 1990s. But the new medications also may present complex side effect profiles, according to the article's author, Dr. Matthew McCoyd of Loyola University Medical Center. McCoyd is a neurologist who specializes MS.
"Today, we stand on the precipice of a changing landscape in MS therapies," McCoyd wrote. "Several new medications have been approved by the U.S. Food and Drug Administration in the United States, and several more are awaiting a final decision or are completing phase 3 clinical trials. The question facing physicians, patients and families is not just a question of remedies, but how to navigate the increasingly complex effective treatment options for MS."
The first effective drug (interferon beta-1B) for the treatment of relapsing forms of MS was approved in the early 1990s.
In recent years, several other effective new drugs have been approved, including fingolimod (Gilenya), teriflunomide (Aubagio) and BG-12 (Tecfidera). Side effects include cardiac and eye problems (fingolimod); diarrhea, nausea and hair thinning (teriflunomide); and flushing, diarrhea, nausea, vomiting and respiratory tract infections (BG-12).
The criteria for diagnosing MS have been simplified and streamlined. This likely will increase the number of patients who will be diagnosed, or at least allow them to be diagnosed at a much earlier time.
Although a single cause of MS has not been identified, there is growing evidence that vitamin D deficiency plays a role. Vitamin D supplementation is a safe and potentially beneficial treatment. But there are fewer data to support other dietary supplements. Nor, contrary to some claims, is there convincing evidence that a diet rich in polyunsaturated fats, omega fatty acids and multivitamins has an impact on disease progression or relapse rate, McCoyd wrote.
McCoyd concludes: "There is no simple therapeutic answer for the treatment of MS, no one-size-fits-all remedy to this notoriously heterogeneous disease. Multiple considerations must be made and understood. However, it is now at least some comfort that patients and their physicians have a rapidly expanding number of options at their disposal."
The article is titled "Update on Therapeutic Options for Multiple Sclerosis."
Loyola University Chicago Stritch School of Medicine