Therapy of multiple sclerosis

introduction

The diagnosis and therapy of multiple sclerosis is of great importance, since an individually adapted therapy can only be initiated through the early diagnosis of the disease, which can reduce the consequential damage of MS.

Therapeutic measures in MS

A therapy that prevents the cause is still not known. Bed rest should be maintained during the thrust and then be physiotherapy and Exercise therapy recommended. The therapy differs depending on the stage at which the patient is.

In the acute stage, the attack is with a Cortisone administration completed. It is given 1g intravenously for 5 days. Tapering off, as is usual with cortisone, is not necessary here. The attack is usually ended successfully, but cortisone has no influence on the long-term development of the disease. The gift is only justified in thrust. Because of the many side effects, the Long-term medication with cortisone is no longer used in MS these days.

To the immediately occurring Side effects counting

• Restlessness
• sleep disorders
• Feeling hot
• Facial flushing
• Gastric ulcer
• and of course the suppression of the immune system.

Because of the stomach ulcers, a stomach protection is also prescribed.

For long-term medication this is Interferon? (Beta) suitable. It usually prevents the third attack and has a positive effect on the entire course of multiple sclerosis. However, it is only prescribed if at least one episode occurs per year.
If the patient only has a relapse every 3 to 5 years (or even less often), the drug is not worthwhile, as this one too Side effects is afflicted. These include, for example Flu symptoms (The patient is therefore advised to take a 500 mg paracetamol tablet beforehand, for example), skin redness and inflammation or allergic reactions. Among other things, the psyche is also influenced. So can depressions, Psychosis or even one increased suicidality (Suicide risk) occur.
Patients who are already tired of life will do so drug not administered. If relapses continue despite therapy with interferon, antibodies can be given as an alternative.
According to statistics, this very new therapy can prevent around 70 percent of the relapses and even up to 80 percent of the im MRI of the brain Lesions seen (magnetic resonance imaging) disappear. However, if the person concerned is already taking other drugs that weaken the body's defense system, these antibodies are not administered. The side effects include viral infections.

If the patient suffers from a chronically progressive form of MS (see above), an A appliesrt chemotherapy (Mitoxantron®). When administering the drug, a maximum dose must not be exceeded. This maximum dose applies to the entire treatment. Once this dose has been reached, the patient is out of therapy. This therapy also has side effects.
Irrevocable heart damage or disorders of the blood composition (too few blood cells due to medication) can result.

Medication

There is no cure for multiple sclerosis. The aim of the therapy is to alleviate the symptoms and to slow down the further progression of the disease.

It is important to treat acute attacks in the short term and to alleviate the symptoms. This is achieved through cortisone preparations that are administered in high doses. This will make the Inhibited inflammationso that the symptoms go away as quickly as possible.

Long-term therapy is also necessary. Since multiple sclerosis is a Autoimmune disease acts, this consists in the treatment of influencing the immune system favorably. This is called this form of therapy Immune modulation and various drugs can be used here. It should early with drug therapy started because damage to the nervous system occurs in the early stages of the disease.

interferon

interferon comes as natural messenger substance in the human body. It is responsible for conveying information between cells. This is used in the treatment with interferon. So it can be achieved that the number of Inflammatory cells decreases. In addition, these cells are prevented from entering the Blood vessels and get into the brain that way. This can prevent the inflammation in the brain and the breakdown of the nerve isolating Myelin sheaths be braked. This is supposed to result in the Frequency of MS attacks decreased and the effects of the damage are kept as low as possible.

To the therapy of multiple sclerosis come so-callede Interferon beta preparations for use. These are injected under the skin or into the muscles. At the start of interferon treatment, this occurs frequently flu-like symptoms, such as fever, chills, and muscle pain as side effects. However, these usually regress after the first months of treatment. For prevention, in consultation with the attending physician anti-inflammatory drugs, how Ibuprofen or Paracetamol be taken. In addition, during the course of therapy there may be redness at the injection site, an increase in liver values, a decrease in white blood cells and depression and insomnia. There is an increased risk of miscarriage for pregnant women within the first 28 weeks.

In some cases it comes to Formation of defense substances (antibodies) of the body against the interferon. This can affect the effectiveness of the drug. The antibodies can be detected in a blood test.

Read more on this topic at: interferon

Glatiramer Acetate (Copaxone)

Treatment with the drug glatiramer acetate (Copaxone®) is an alternative to interferon therapy. The time between two flare-ups is increased and the Effects of the disease are mitigated.

The exact mechanism of action is still unclear, but it is assumed that glatiramer acetate (Copaxone®) causes the Decreased number of certain harmful cells becomes. The drug is injected under the skin just like interferon beta. However, there are far fewer flu-like side effects. The most common side effect of treatment with Glatiramera acetate (Copaxone®) is one Skin reaction at the injection site. In addition, chest pain, facial flushing, sweating, shortness of breath and a drop in blood pressure can occur.

Fumarate (Tecfidera®)

Fumarate (Tecfidera®) is another drug used for Long term therapy multiple sclerosis is used. It is in the form of Dimethyl fumarate (Tecfidera®) and, in contrast to the other two basic drugs, is in the form of Tablets taken orally.

On the one hand, fumarate (Tecfidera®) works anti-inflammatory and on the other it protects the healthy nerve cells by inactivating cell-damaging substances.

This will reduce both the number of MS attacks and the extent of damage to the brain. Early treatment with fumarate is common Gastrointestinal complaints before, which should, however, subside within a few weeks.
In some cases, however, this side effect can be so pronounced that it leads to treatment with Tecfidera being discontinued.
Furthermore, there is a flush under Tecfidera. This is a harmless, but uncomfortable sudden reddening of the skin. Usually a flush starts in the face and then slowly spreads over the entire body. The affected person has an uncomfortable feeling of heat and burning sensation on the skin.
Here, too, the severity of the symptoms is very individual and very different. The frequency of the flushes also varies from case to case.
Please also read our article on this Flush syndrome

It should be a regular Control of the blood count carried out in order to be able to detect a possible infection at an early stage.