Multiple Sclerosis Cure – What to expect?

MS is a chronic, inflammatory, autoimmune disease that interferes with the communication between the brain and other body parts. Studies showed that multiple sclerosis (MS)[1] still doesn’t have a proper treatment regimen, but scientists have made considerable progress in discovering new medicines to treat it. There are already studies that create new and improved a multiple sclerosis cure called disease-modifying therapies (DMTs) for this autoimmune disease.

DMTs are also crafted purposely in order to reduce the frequency of MS attacks and their intensity. The development of impairment and brain volume mass loss can also got stop by the DMTs. Since the early 1990s, DMTs approved by the Food and Drug Administration (FDA) have been successful in controlling relapsing remitting MS[2], which affects between 85% and 90% of individuals diagnosed with this condition.

Multiple Sclerosis Research

After many years, research on some individuals showed that relapsing remitting MS creates a transition to secondary-progressive MS. DMTs currently do not affect on this period, so it is safer to set a treatment plan at this period. 

At the beginning of this condition, approximately 10% of people with MS had a primary-progressive MS. As a result, no doubt that finding a new cure against this dilemma is crucial.

The good thing is, the Food and Drug Administration (FDA) had finally approved a new multiple sclerosis cure. Today, Mayzent (Siponimod) tablets have been approved by the U.S. The treatments aim at adults with relapsing MS, including clinically isolated conditions, relapsing-remitting ms, and active progressive secondary disorder.

“Multiple sclerosis can have a profound impact on a person’s life,” said Billy Dunn, M.D, director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research. “We devote to work with companies that are developing additional treatment options for patients with multiple sclerosis.”

How To Diagnose Multiple Sclerosis?

Most people between the ages of 20 and 40 experience their first MS symptoms. In young adults, MS is among the most common causes of neurological impairment that occurs often in women. Smoking in adults, or lacking vitamin D are the main reasons why people get MS frequently.

MS begins with a relapse and remit course for most individuals. In here, rehabilitation times (remitting ms) are accompanied by episodes of deteriorating function (relapsing ms). Such remissions may not be complete and may leave a degree of residual impairment in patients.

There is a degree of chronic impairment in many, but not all people with MS that progressively worsens over time. Disability can improve in some patients independent of relapses, a process called secondary progressive multiple sclerosis (SPMS). Many patients continue to experience relapses in the first few years of this process, a phase of the illness identified as active SPMS. The medications approved for the treatment of relapsing forms of MS can apply for the treatment of active SPMS. Later, several SPMS patients avoid having new relapses, but impairment, a process called non-active SPMS, continues to improve.

Examination on MS

There are no standardized tests for the diagnosis of multiple sclerosis. However, it depends on ruling out other disorders, known as a differential diagnosis, that may cause similar signs and symptoms. 

In the first phase, doctors will have a thorough medical examination to find a suitable treatment for your conditions. Thereafter, your doctors can recommend the following:

  • Spinal tap (lumbar puncture)[3] – a diagnostic test wherein a small amount of cerebrospinal fluid is removed for laboratory examination from the spinal canal. Antibodies that are associated with MS can display irregularities in this study. A spinal tap can also help to rule out diseases and other problems with MS-like symptoms.
  • MRI[4] – This is another test that can reveal areas of your brain and spinal cord that have MS (lesions). You may receive a contrast substance intravenous injection to highlight lesions. It may suggest whether or not your illness is in an active phase.
  • Blood tests[5] – Extracting blood from the patient is the typical procedure in determining the condition. The test also helps rule out other diseases with MS-like symptoms. Tests to search for particular MS-related biomarkers currently show improvement and can also help diagnose the disease.
  • Evoked potential test[6] – A kind of experiment in which the electrical signals are brought by the nervous system to respond to particular recorded stimuli. Visual stimulation or electrical stimulation can apply in an evoked potential test. In these specific tests, you will see a moving visual pattern, or a short electrical impulse. The impulse is added to nerves in your limbs. After this, electrodes calculate how fast the data passes through the nerve pathways.
multiple sclerosis cure
Multiple sclerosis under MRI scan

New Multiple Sclerosis cure

Ocrelizumab

Disease modifying therapies for primary-progressive MS, only Ocrelizumab (Ocrevus) got the FDA approval in 2017. In this type of MS, this medication decreases the relapse rate and risk of impairment progression. It is also the first DMT to delay the progression of the primary-progressive form of MS. Researchers are learning more about how current DMTs work to minimize relapses and decrease brain lesions associated with MS. Further research can decide if these mechanisms will postpone impairment caused by the disease. 

Mayzent

In contrast, the FDA also approved Mayzent (Siponimod) as one of the effective multiple sclerosis cure in 2019.  For relapsing-remitting and secondary-progressive forms of MS, this tablet is a taken medicine and a registered drug as well. It is an immune-modulating treatment that helps minimize both relapses and impairment progression. The side effects have not been examined.

In a clinical trial of 1,651 people contrasting Mayzent to placebo, its effectiveness was demonstrated in people with SPMS. Those patients showed evidence of impairment improvement in the previous two years and no relapses in the three months before enrollment. The study’s primary endpoint was the time to three-month confirmed disability progression. In the Mayzent group, the fraction of patients with confirmed was statistically lower than in the placebo group. The relapses experience numbers reduced thanks to Mayzent. The effects were not statistically important in the subgroup of patients with non-active SPMS.

A Prescription Guide that explains substantial details regarding the uses and risks of the drug must be dispensed with Mayzent. This treatment can increase the risk of infections, so before beginning, patients should have a full blood count taken. This type of multiple sclerosis cure can cause side effects called macular edema[7], so if they experience a vision change, patients should contact their physician. Mayzent can cause temporary decreases in heart rate and may cause lung function to decline. During treatment, health care practitioners should monitor the blood pressure of the patient.

Multiple Sclerosis Cure
Mayzent tablets

Due to the potential risk of fetal damage, patients with posterior reversible encephalopathy syndrome[8] and patients treated with immunosuppressive/immune-modulating treatments should be supervised because unintentional additive immunosuppression can occur with Mayzent. Headache, high blood pressure, and liver function change are the most common adverse reactions in patients receiving Mayzent.

Cladribine

Another oral tablet approved by the FDA in 2019 to treat relapsing-remitting and secondary-progressive MS is Cladribine (Mavenclad). Cladribine can decrease the progression of impairment and relapse rates in clinical trials. Cladribine is well-known because of safety concerns as individuals do not take other medications for MS or those medications don’t successfully work out. 

Transplantation of stem cells also goes through various tests as a multiple sclerosis cure. Researchers are studying whether the immune system can “reset” the immune system by killing and replacing it with transplanted stem cells.

Moreover, Diroximel fumarate[9] (Vumerity, Biogen Inc and Alkermes plc) delayed-release oral capsules have been licensed by the FDA in adults for the treatment of clinically isolated multiple sclerosis (MS), relapse and remit conditions, and active progressive secondary disorder.

According to the release, approval has formed on the basis of a new drug application (NDA). This contains data from pharmacokinetic bridging studies comparing Vumerity with Tecfidera. The NDA also developed bioequivalence and relied on Tecfidera’’s findings of protection and efficacy from the FDA. These disease modifying therapies are highly expected to make progress in medical research, thus can give proper treatments to people with various types of MS.

Multiple Sclerosis cure – Immunotherapy

Immunotherapy

In order to accomplish prevention and/or therapeutic objectives, immunotherapy focuses on the principle of modulating the immune system. As evidence of immune system in the development of multiple sclerosis has evolved, scientists carried out experiments on diverse new treatments to modify or suppress the immune response. Many of these treatments are experimental at this time. 

Clinical studies have shown that immunosuppressive agents and techniques may have a beneficial effect on the course of MS, at least when those treatments are still under the treatment. Generalized immunosuppression on the lower side leaves the patient open to a range of viral, bacterial, and fungal infections.

A number of immunosuppressant multiple sclerosis cure have been studied by MS investigators over the years. Novantrone (mitoxantrone), one such medication, was in U.S approval. The Administration of Food and Drugs (FDA) for the treatment of advanced or chronic MS. Cyclosporine[10] (Sandimmune), cyclophosphamide (Cytoxan), methotrexate[11], azathioprine (Imuran), and complete lymphoid irradiation are other treatments being tested. Lymphoid irradiation is a procedure in which the lymph nodes of the MS patient are irradiated for a few weeks small doses of with x-rays to kill lymphoid tissue, which involves in the degradation of tissue in autoimmune diseases. 

Inconclusive and/or conflicting findings of these studies, along with the potentially dangerous side effects, indicate the need for more research to determine what, if any, role they can play in MS management. Studies are also being performed with the drug cladribine (Leustatin) modulating the immune system.

monoclonal antibodies

Another possible therapy for MS is monoclonal antibodies (MAB or MoAb). This treatment is laboratory-antibodies products that are highly selective for a single antigen. In the hope that they will alter the patient’s immune response, they are shot into the patient. One monoclonal antibody is natalizumab[12] (Tysabri), which has been shown to substantially reduce attack frequency in people with relapsing types of MS in clinical trials and was approved for marketing by the FDA in 2004. Regarding MS, Tysabri can work by reducing the ability of inflammatory immune cells to bind to and move through the blood-brain barrier cell layers. 

plasmapheresis

Plasma exchange, or plasmapheresis, is another experimental therapy for MS. Plasmapheresis is a process that extracts the patient’s blood and separates the blood plasma from other blood substances that may contain antibodies and other materials that are immunologically active. They discard these other blood substances and then transfuse the plasma back into the patient. This experimental treatment remains at the stage of clinical testing because its value as a therapy for MS and side effects have not been proven. 

Stem Cells transplantation

Bone marrow transplantation is a process in which a healthy donor’s bone marrow is injected into patients who have undergone medicine or radiation therapy to weaken their immune system so that the donated marrow is not rejected. Studies also investigated on injections of venom from honey bees. The risk of potentially serious side effects lies in each of these therapies.

A dynamic network of cells and organs is the immune system. The bone marrow, thymus gland, spleen and lymph nodes work together to protect the body against attacks by “alien” invaders. The immune system is once again the primary defense of the body against infection and illness. In several ways, the immune system can work against diseases, including MS. For example, in the body, the immune system can recognize the difference between healthy cells and cancer cells and work to get rid of cancer cells. The immune system, however, is not always able to identify cancer cells as “foreign.” 

In different ways, immunotherapy acts on the immune system by restoring, stimulating or strengthening the responses of the immune system.

Frequently Asked Questions

Can MS be cured if caught early?

Early treatment provides the best treatment for your conditions. DMTs and other therapies may reduce pain and help you better manage your condition.

How long can you live with multiple sclerosis?

According to the National Multiple Sclerosis Society (NMSS), the most people who suffer from MS will experience a relatively normal life span. On average, most people with MS live about seven years less than the major population.

What is end stage MS?

When a patient with MS begins to experience pronounced complications, this is endstage MS happens. Some of its symptoms may occur: Limited Mobility – Patient may have no ability of doing daily activities.

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  1. National Multiple Sclerosis Society. 2018 [Dec.14, 2018]. What is multiple sclerosis? Available from: https://www.nationalmssociety.org/What-is-MS.
  2. R.A. Rudick, E. Fisher, J.-C. Lee, et al and the Multiple Sclerosis Collaborative Research Group. 1999 [Nov.1, 1999]. Use of the brain parenchymal fraction to measure whole brain atrophy in relapsing-remitting MS. Available from: https://n.neurology.org/content/neurology/53/8/1698.full.pdf
  3. Mayo Clinic. 2020. Lumbar puncture (spinal tap). Available from: https://www.mayoclinic.org/tests-procedures/lumbar-puncture/about/pac-20394631
  4. Judith Marcin, Peter Lam. 2018 [July 24, 2018]. What to know about MRI scans. Available from: https://www.medicalnewstoday.com/articles/146309
  5. Chad Haldeman, Lu Cunningham, Raymond Turley Jr. Basic metabolic panel (blood). Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=basic_metabolic_panel_blood
  6. Martin Hardmeier, Letizia Leocani, & Peter Fuhr. 2017. A new role for evoked potentials in MS? Repurposing evoked potentials as biomarkers for clinical trials in MS. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564950/
  7. National Eye Institute (NEI). 2019 [July 8, 2019]. Macular Edema. Available from: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/macular-edema
  8. Esther V. Hobson, Ian Craven, and S. Catrin Blank. 2012. Posterior Reversible Encephalopathy Syndrome: A Truly Treatable Neurologic Illness. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3524908/
  9. National Center for Biotechnology Information (2020). PubChem Compound Summary for CID 73330464, Diroximel fumarate. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/Diroximel-fumarate.
  10.  University of Illinois, Drug Information Group. 2020 [October 5, 2020]. Cyclosporine, Oral Capsule. Available from: https://www.healthline.com/health/cyclosporine-oral-capsule
  11. American Society of Health-System Pharmacists. 2017. Methotrexate. Available from: https://medlineplus.gov/druginfo/meds/a682019.html
  12. Michael Hutchinson. 2007. Natalizumab: A new treatment for relapsing remitting multiple sclerosis. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936307/