Multiple Sclerosis Treatment by Keely Perry

8/11/2019 Multiple Sclerosis Treatment by Keely Perry

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Multiple Sclerosis & Treatment

of Progression with Interferon-

Beta-1a


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What is Multiple Sclerosis? Most commonly defined as an

autoimmune disease that affects the CNS Characterized by the loss and/or damage

of the myelin sheath

Loss of myelin sheath results in theinability of neurons to transmit neuralsignals properly, causing the manysymptoms of MS

Unpredictable and no known cures


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Anatomy of the Neuron


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Four Major Varieties of MS Relapsing/remitting (RRMS)

Characterized by periods of flare-ups and

remission

Accounts for 85% of MS patients

Primary Progressive (PPMS)

Slow continuous worsening of disease from

onset Only about 10%


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Four Major Varieties of MS

(cont.)

Secondary Progressive (SPMS)

Initial period of relapsing-remitting, then

steady worsening of disease 50% of patients diagnosed with RRMS

develop into this variety within 10 yrs withoutdrug treatment

Progressive Relapsing (PRMS)

Steady worsening with acute relapses

Different from RRMS in that diseaseprogresses during relapses


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What Causes MS? Not exactly known

Several theories

Most commonmyelin damage results

from abnormal response in the immunesystem

T cells (type of white blood cell) attack myelin

Though to be triggered by environmentaland/or genetic factors


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Many other theories

MS is pathogen-mediated

Research suggests Chlamydia Pneumoniae

and other pathogens may trigger MS Genetics

Identical twin studies-> one has MS, other has

30% chance

No specific gene/s found yet

Most likely involves a combination


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MS Geography Typical onset between ages 20-50

Reduces life expectancy by about 10-15 yrs

About patients survive 30+ yrs from onset

Affects 2-3 times as many women than men

Research suggests that genetic factors play a

role

More common among people of Europeandescent

About 400,000 Americans have MS


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Symptoms of MS

Wide variety due to nature of disease

Different classifications of symptoms

Visual

Motor

Sensory Cognitive

Coordination/Balance

Bowel, Bladder, and Sexual


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Diagnosis of MS No single test for diagnosing MS

Usually diagnosed when all other

possibilities ruled out

Many tests Medical history

Nervous system functioning

MRI, Evoked potential tests, spinal tap


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Basic Rule for Diagnosis

Est. by committee sponsored by NMSS in

1965

Must have BOTH of the following: Evidence of myelin loss in at least 2 areas

occurring in different places at different times

Any other diseases that could account for the

above have been ruled out

Revised in 1983 by Poser to take intoaccount advances in MRI technolo


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Treatments for MS No known cure

Treatments involve relieving the symptoms

or slowing the progression of the disease

These are mostly drug treatments Also CAMs- Complementary and

Alternative Medicine


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CAMs Used with or instead of conventional drug

treatments Some include

Acupuncture Herbal medicine

Yoga

Relaxation techniques

Hypnosis


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Conventional Drug Treatments

Disease-modifying drugs*

ABC Treatments

Chemotherapeutic Agents Corticosteroids & ACTH

Drugs that help with symptoms Wide variety from anti-depressants(depression) to laxatives (bowel dysfunction)

to anti-convulsants (pain/altered sensations)


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ABC Treatments

Most popular drug treatments for

modifying course of disease

Work by regulating aspects of theimmune system

ABC refers to the 3 major brand namesof this category of drugs: Avonex,

Betaseron/Betaferon, and Copaxone

Also now added Rebif and Novantrone


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ABC Treatments Cont.

Interferon beta-1a

Avonex, Rebif

Interferon beta-1b Betaseron/Betaferon

Glatiramer acetate Copaxone

Mitoxantrone

Novantrone


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What are Interferons? Occur naturally in human body

Proteins that prevent viral multiplication bystimulating the production of antiviral

proteins in normal cells Interferon-alpha, Interferon-beta, and

Intereron-gamma


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Avonex

Interferon-beta-1a

Used for RRMS and SPMS w/relapses

Produced by recombinant DNA

technology using genetically engineered

Chinese Hamster Ovary cells into whichthe human interferon beta gene has been

introduced

The resulting amino acid sequence is


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Avonex

Mechanisms by which it exerts it effectsnot fully understood

Pharmacokinetics in MS patients notevaluated

Recommended dosage of 30 mcg to be

injected intramuscularly one weekly Not recommended subcutaneously- adverse

reactions mainly at site of injection*

No known interactions with other drugs


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Current Avonex Research

Avonex fairly new

Lots of research being done, few consistent

findings yet Most research with Avonex focuses on:

Comparison with other drugs of its type

Testing properties of the drug by altering

dosages,etc.

Seeing how well drug modifies diseasecourse in placebo studies


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Future Research on MS

Finding the cause

Stopping/slowing progress of disease

Repairing damage already done

Remyelination

Better ways of treating symptoms Focusing on the social implications


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Recommended Websites to

Learn More http://www.avonex.com

http://www.nationalmssociety.org

Multiple Sclerosis Treatment by Keely Perry

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