Living with Advancing Multiple Sclerosis: Latest Treatments for Multiple Sclerosis

Part I - Introduction

Dr. Apatoff: Many years ago the doctor wouldn’t even mention multiple sclerosis even though he understood that that was the probable diagnosis because there were really no effective treatments to offer, and they didn’t want to frighten the patient. 

In the last 10 to 15 years, there has been a revolution of therapeutics for multiple sclerosis. It’s unlike any other area of neurology, and for that matter medicine, where patients that previously would be looking at relentless disease progression and ongoing relapses, we now have many medications that can control disease at the very earliest signs, so that patients go for many years, decades without any significant disease activity.

CJ: Between the treatments and the research these days, MS doesn’t have to be looked at as a diagnosis of being in a wheelchair. I kept leading the same life I’d always lived. I kept playing softball and going to work, and working hard, working 24-7.

Dr. Apatoff: So I think the changes began in the early 1990’s with the advent of Interferons, these are injectible biologic proteins. A natural protein that your body makes. And the treatments have been further refined over the past 10 years.

There are now several new injectible, infusable medications, what we call Monoclonal Antibodies. These monoclonals target specific immune proteins, and are able to block or intervene with the inflammatory mechanisms of multiple sclerosis at a very precise level.

And also there are now oral therapies. We’re now moving from injectible medications into oral agents which are also very promising.

We’re very optimistic now about our ability to manage multiple sclerosis even the more aggressive patterns of multiple sclerosis.

Part II - Dr. Apatoff with Patient

Dr. Apatoff: Now the medications has been going well, you’ve been pretty compliant with the daily injections?

Angela: It’s OK, I do it, I do complain of the bumps

Dr. Apatoff: But it’s a small sacrifice

Angela: Oh absolutely, the medication has been doing wonders for me, so like I said, I can deal with bumps.

Angela: The treatments for MS have come so far, so I’m definitely staying more positive. I’m staying on my medication which I didn’t want to do before, but I’m staying on the medication and hopefully it all works out.

Part III - Conclusion

Dr. Apatoff: The strategy for multiple sclerosis is now, once the patient presents with mild/severe symptoms, we put the patient on immediate therapy that is preventative, that reduces the potential for future episodes. We don’t wait for a second attack. The best clinical outcomes require us being very proactive and instituting the appropriate course of treatment depending on the nature of the patient’s symptoms.

So it has taken a complete polar opposite approach to how we used to treat multiple sclerosis a couple decades ago. It’s educating the patient about all the complexities of their condition and all the possible therapies we have to offer them.