What the Future Holds

Multiple sclerosis (MS) is a chronic disease that attacks the body’s central nervous system. Over time, MS destroys the protective coating (myelin) that covers and protects nerves. MS can be debilitating, and for the 300,000 Americans who live with the disease, there is no cure. Medications for people with MS are designed to ease the symptoms of the disease and make relapses less severe. However, in recent years, advancements in medical research and understanding of how the disease works have made it possible for doctors and scientists to design better, smarter medicine.

In any year, as many as a dozen MS-related studies are ongoing. Each study, even studies in the earliest stages of clinical research, brings scientists and doctors one step closer to understanding MS. What causes it, who gets it, how to stop it, and how to cure it are still mysteries, but researchers are coming ever closer to answers. Here, the treatments scientists and doctors are exploring now.

Newly Approved Treatments

The U.S. Food and Drug Administration (FDA) approved the drug Tecfidera (dimethyl fumarate) for treatment of relapsing forms of MS in March 2013. It is the third oral medicine to be approved for the treatment of MS. Clinical research on the medication showed that patients who took the medicine once daily experienced worsening of disabilities less often than patients who took a placebo. Specifically, Tecfidera cut the relapse rate in patients with MS by 44 percent in one trial and 53 percent in another. Side effects of the medicine include decreased white blood cell count, flushing, nausea, and diarrhea. Doctors will need to monitor a patient’s white blood cell count in order to prevent opportunistic infections.

Future Drug Therapies

The medicines that are currently being studied for their effectiveness at treating or preventing MS relapses include:

  • Alemtuzumab – Alemtuzumab is currently indicated to treat leukemia. However, Stage I and Stage II tests with the once-a-year injected medicine show that it also may be effective at slowing the accumulation of MS-related disability and reducing the rate of relapse. In trials, alemtuzumab was still effective one year after the initial injection. Eighty percent of patients who received a second dose one year after their initial injections did not require additional treatments.
  • Laquinimod – Most MS medications are given by injection or IV infusion—only three (Tecfidera, Aubagio, and Gilenya) are available as oral medication. Laquinimod, a once-daily medicine, could become the fourth oral medication prescribed to treat the symptoms and relapses of MS. Clinical trials show that laquinimod is efficient at significantly reducing relapse rates and slowing both acute (short-term) and chronic (permanent) disability. The medicine also appears to be effective at preventing additional brain atrophy.
  • Daclizumab – Research suggests the injectable medicine daclizumab may be effective at reducing new or enlarged brain lesions. In fact, one study found injections of the medicine likely caused a 72 percent reduction in both new and enlarged brain lesions in patients with MS. Additionally, people who received the injections had lower recurrences of MS relapse than people taking a placebo. As with all trial-studied medication, daclizumab needs additional research—several patients in study groups suffered serious adverse side effects (other than MS relapse) that may have been connected to the medicine.
  • Ocrelizumab – Patients in long-term clinical studies of the injectable drug ocrelizumab show a reduced occurrence of brain lesions related to MS. Additionally, long-term follow-up with these patients shows that the medicine is effective up to 18 months after a dose. The latest developments in the research also suggest that patients who receive as many as four injections of the medication do not show increased or new MRI activity (a sign that MS is not progressing).

The Future in Research

Genetic Research

There is no cure for MS, and there is no known cause of it, either. Research suggests that several factors causes—from environmental factors to vitamin deficiencies—may play a role in the development of the disease. Scientists and researchers are working to identify a single cause—or causes—of MS. Also, they hope to discover what factors determine how the disease will progress. If the research is successful, doctors may be able to identify MS in patients and intervene early, possibly even before the disease has begun to cause symptoms.

Repairing damage caused by MS

Despite advances in medicine that seem to slow and possibly halt the progression of MS, no medicine is able to reverse the damage caused by MS and restore a person’s nervous system to a healthy, full-functioning system. For now, once MS destroys the myelin on a nerve, it cannot be regenerated. However, a major goal of research is to find a way to promote the regrowth of myelin, or re-myelination. Thus far, researchers have used human embryonic stem cells, adults stem cells, and growth factors (substances that affect how a cell grows) to see if any of these may hold promise for repairing the damage MS does. Though there have been no major successes yet, research in this area continues.