Multiple Sclerosis

In this Article

• What is multiple sclerosis?
• What causes multiple sclerosis?
• Is multiple sclerosis inherited?
• What are the types of multiple sclerosis?
• What are the symptoms of multiple sclerosis?
• How is multiple sclerosis diagnosed?
• How is multiple sclerosis treated?
• Interferon
• Other medications
• How are the manifestations of multiple sclerosis treated?
• What are the future directions for managing multiple sclerosis?
• Multiple Sclerosis At A Glance
• Patient Discussions: Multiple Sclerosis - Symptoms at Onset of Disease

Other medications

Glatiramer acetate

Glatiramer acetate (Copaxone) is another disease-modifying drug that is approved for reducing the frequency of relapses in RR-MS. Glatiramer acetate is a synthetic (man-made) amino acid mixture that may resemble a protein component of myelin. It is thought that the immune system reaction against myelin in multiple sclerosis may be blocked by glatiramer acetate. A reaction occurring immediately after the injection of glatiramer acetate is common, affecting one out of 10 patients. The reaction may involve flushing, chest pain or tightness, palpitations, anxiety, shortness of breath, tightness in the throat, or hives. The reaction usually resolves within 30 minutes and requires no treatment. Some patients may be at risk of developing lipoatrophy, inflammation and destruction of tissue beneath the skin at the site of injection. Glatiramer acetate is used for reducing the frequency of relapses in patients with relapsing-remitting multiple sclerosis.

Natalizumab

Natalizumab (Tysabri®) is a drug approved by the FDA to treat multiple sclerosis. Natalizumab is a monoclonal antibody against VLA-4, a molecule required for immune cells to adhere to other cells, penetrate the blood brain barrier and enter the brain. It is administered via monthly intravenous infusions. It carries a warning for a potentially fatal disease, progressive multifocal leukoencephalopathy (PML), a viral infection of the brain that usually leads to death or severe disability. For this reason only patients who have signed up for treatment under a controlled drug distribution program can get this treatment.

Natalizumab is used as monotherapy for the treatment of patients with relapsing forms of multiple sclerosis to delay the progression of physical disability and reduce the frequency of clinical relapses. The safety and efficacy of natalizumab beyond two years are unknown. Because natalizumab increases the risk of PML, it is generally recommended only for patients who have had an inadequate response to, or are unable to tolerate alternate multiple sclerosis therapies.

Mitoxantrone

Mitoxantrone (Novantrone®) is also approved by the FDA for the treatment of multiple sclerosis. Mitoxantrone is a chemotherapy drug that carries the risk of serious cardiac side effects or cancer. Because of these serious side effects, physicians tend to reserve its use for more advanced or worsening cases of multiple sclerosis.

Mitoxantrone is used for reducing neurologic disability and/or the frequency of clinical relapses in patients with secondary (chronic) progressive, progressive relapsing, or worsening relapsing-remitting multiple sclerosis (for example, patients whose neurologic status is significantly abnormal between relapses). Mitoxantrone is not used in the treatment of patients with primary progressive multiple sclerosis.

Multiple Sclerosis - Symptoms at Onset of Disease

The MedicineNet physician editors ask:

The symptoms of multiple sclerosis can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

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