From multiple sclerosis more than 160 drugs have been created, each of which is less or more popular in different countries Oh. Neurologists say that a cure for multiple sclerosis will be invented in the near future. But so far, there is no medicine that is guaranteed to eliminate the cause of the disease.
Multiple sclerosis is autoimmune pathology, the causes of which cannot be fully established. This makes it difficult for physicians to seek effective drugs. But you can use drugs that slow down the course of multiple sclerosis.
An experienced neurologist is able to choose a therapy regimen that will prolong a person's life by 10-15 years until the moment of disability.
: medicines for elimination acute conditions, drugs to inhibit the disease, means to improve well-being. Their use is not interchangeable, medicines must complement each other in different periods activation of the RS.
Medications for exacerbations
For the treatment of exacerbations of multiple sclerosis, drugs consisting of corticosteroid hormones are used. They have serious advantages, as they significantly inhibit the activity immune system. At the same time, corticosteroids have a pronounced anti-inflammatory effect.
The most common substances used in MS: tableted prednisolone, dexamethasone, methylprednisolone.
The last two substances are used only intravenously and have an enhanced effect. However, hormones cannot be used constantly: side effects develop, violations of the instructions can lead to death.
In some cases, hormones do not help patients, then blood purification is prescribed.
Plasmapheresis is a procedure in which a person's blood is driven through a special apparatus. This destroys some elements and changes the composition of the blood.
Botulinum toxin
The toxin is obtained from specific bacteria. It contains protein, and the substance itself belongs to the group of neurotoxins that inhibit the activity of certain fibers. Botulinum toxin relieves muscle spasms in MS.
Used for therapy different types substances. They block the breakdown of acetylcholine, which amplifies nerve signals in muscles, causing spasms. After some time after the start of taking the medicine, the muscles relax.
The toxin is administered intramuscularly, and the first effect occurs after a week of treatment. The effect remains for 5-7 months. Doctors prescribe injections once every 3 months to maintain the effect. However, it should not be used if large muscle spasms have occurred.
Side effects of the drug include: muscle weakness, limited mobility, flu symptoms.
1-2 days after the introduction of the substance into the body negative symptoms passes. A small number of patients develop resistance to the substance as the body begins to produce antibodies to the toxin.
PITRS registered in the Russian Federation
Drugs for the treatment of multiple sclerosis - MSMS - are aimed at slowing the disease. In the Russian Federation, there are several accepted groups of medicines. Means of the "first line" are glatiramer acetate and interferons of all types:
- Beta interferon. Neurologists prescribe drugs for therapy Russian production: "Infibeta", "Ronbetal", "Interferon beta 1b". Also used german drug"Betaferon" and the Swiss medicine "Extavia".
- Interferon beta for subcutaneous injection . In this group, 2 medicines are approved: the Italian "Rebif" and the Argentinean "Genfaxon".
- Interferon beta for intramuscular injection . The most commonly prescribed is Avonex, which is produced in different countries European Union, as well as SinnoVex, created in Iran.
- . They are produced only in Israel, the medicine is called Copaxone-Teva. Similar remedy began to be created in 2016 in Russia, experimental treatment has already begun. The drugs are called "F-Synthesis" and "Axoglatiran".
Second-line drugs are prescribed less frequently, but are also highly effective. These include drugs based on natalizumab, laquinimod, fingolimod. Funds are produced in Israel and Europe.
Choose a medicine for multiple sclerosis, depending on the stage of the disease, the characteristics of the symptoms. In this case, the appointment of drugs is possible if the condition meets certain requirements:
- Early treatment. If relapsing-remitting MS is diagnosed, the patient has experienced 2 or more exacerbations over 2 years. In secondary progressive MS with 2 exacerbations in 2 years.
- EDSS Severity Assessment. The degree should not be more than 6.5 points, then you can use PMT for the treatment of sclerosis. It is also important to consider at this stage that no multiple sclerosis medications have been used before.
- Patient Consent. The person is informed about the possible outcomes side effects. At the same time, he must agree that it is necessary to constantly visit a doctor and monitor the effectiveness of therapy.
- Choosing the optimal active substance . Thus, interferons of all types are used in relapsing-remitting MS. And in the secondary only certain types.
- Person's age. Not all drugs can be used to treat MS before 18 years of age.
The appointment of drugs for the treatment of multiple sclerosis is carried out only on a special medical commission with the study of clinical studies. Must be accompanied by parental consent to therapy.
It is not possible to treat MS with interferons in the presence of certain diseases, including mental disorders:
- suicidal thoughts, depression;
- decompensatory stage of liver disease;
- epilepsy;
- pregnancy and breastfeeding;
- severe heart disease;
- hypersensitivity to active components.
These contraindications apply to interferons. Glatiramer: sensitivity, pregnancy and panic attacks.
This group includes drugs that eliminate the symptoms that complicate a person's life.
Some patients require the restoration of the digestive process, the elimination of constipation. For this, magnesia, bisacodyl, docusate are used. Dysfunctions of urination are removed by drugs darifenacin, tolterodine and tamsulosin.
Innovative Treatments
New drugs are drugs that are under study and testing. They are used as part of experimental therapy and often give impressive results.
Dimethyl fumarate is a unique substance for the treatment of multiple sclerosis, used in severe degrees.
Other new medicines also have good efficacy: Fingolimod, Alemtuzumab, Daclizumab. All of these drugs are included in the group of immunosuppressive drugs that suppress the activity of the immune system. Many of these medicines have previously been used in the treatment of other serious pathologies, but for the treatment of MS have become used recently.
LINGO-1 the latest remedy for the treatment of multiple sclerosis, which is under trial. It restores the myelin sheaths of nerve endings throughout the nervous system. Scientists believe that this drug could make a significant breakthrough in the field of MS therapy.
In Russia, drugs for multiple sclerosis are not used in full. Significant bans on foreign drugs limit the possibilities of patients, but medicine offers Russian developments that also prove their effectiveness.
On the this moment There are three types of treatment for the disease:
- Treatment is carried out exclusively during periods of exacerbations.
- symptomatic treatment.
- Preventive therapy (treatment with drugs that change the course of MS).
Each of the presented directions is applied at the stage corresponding to it. Therapy main goal puts a decrease in the frequency of exacerbations, and maximal slowing of MS progression.
What determines the effectiveness of treatment? From many factors, in particular:
- the rate and type by which the disease progresses;
- how often there are exacerbations;
- timely compliance with the doctor's instructions by the patient.
Features of drug therapy
Pills help control the course of sclerosis. For instance:
- Interferon beta 1b (this medicine is also available under the names Ektavia and Betaferon).
- Glatiramer acetate (also known as Copaxone or Glatirate).
This group of drugs is known for its ability to reduce the number of exacerbations. Copaxone and Interferon are injected.
- Interferon beta 1 a, fingolimod, mitoxantrone, dimethyl fumarate reduce the severity of exacerbations, maximally prevent its progression.
- Gilenya, Aubagio, Tekfidera are used orally to treat relapsing forms of MS.
What is shown during exacerbations?
The basic remedies listed above help prevent an exacerbation, but during the exacerbation itself they are practically useless.
If light form, then you can do without therapy at all. But if the patient is in any way impaired mobility, due to which he is not able to carry out daily activities, for the speedy completion of the exacerbation, the doctor can do intravenous injection steroids. This does not affect the course of the disease in general, but helps to quickly remove the outbreak.
Sometimes in such cases, the doctor may prescribe a plasmapheresis procedure - it is done as follows: a certain amount of blood is taken from the patient, it is divided into fractions (blood cells and plasma), the plasma is replaced, the blood is transfused back. This technique is only used in severe cases relapses that are not amenable to correction with steroids.
Tablets for sclerosis
Despite the fact that the cure for this disease is still unknown, in any case, official medicine does not know them, there are many drugs that change the course of the disease. Below is a list of these medicines and brief information about them.
| Empire style | Ampyra (dalfampridine). Used to improve walking in patients. It optimizes communication between damaged nerve cells and improves their nerve function. |
| Avonex | Used for relapsing MS. The medicine works best for those who have already experienced the first episode of the disease and who have signs of MS on MRI scans. |
| Betaferon | Used in the process of recovery from attacks of recurrent forms of the disease. The drug is administered as an injection into the space under the skin. |
| Rebif | Taken for the treatment of MS in a relapsing form. It is administered as an injection three times a week. |
Preventive medicines for sclerosis
These are the drugs that change the course of the disease and can slow it down. further development. But most of them are used intramuscularly.
Tablets, for example, are rarely used for this.
The dose and regimen must be developed by the doctor. and the whole process of treatment must be under his control.
This is very important, because the drugs are quite strong and can cause side effects. For instance:
- To slow down the development of the disease - beta-interferons, for example, Betaferon, Anoneks. Side effects: These drugs can harm the liver and cause liver disease.
- To protect myelin cells from attacks by the immune system - Copaxone.
- Means that protect the brain and spinal cord from getting immune cells into it - Tisarbi. It increases the chance of a brain infection.
- Intercepts immune cells in the lymph nodes Fingolimod (Gilenia). But it has a side effect unpleasant effect- this is an increase in pressure and deterioration of vision (albeit for a while).
- Mitoxantrone (Novantrone) is an immunosuppressant. The drug reduces the activity of the immune system. But there is a possibility that it may be associated with the development of blood cancer.
IMPORTANT! All of the above drugs have been tested by numerous studies, and helped a large number patients. But they also cause these side effects and in no case should be used for self-medication. All drugs must be prescribed by a doctor.
Medications to relieve symptoms
The remedies that belong to this group are designed to improve the patient's condition and make the disease progress as slowly as possible.
vitamins
It is better to get vitamins from food. For instance:
- vitamin A: in blueberries and carrots, fresh fruits and vegetables, fish and eggs;
- B vitamins contained, for example, in rye bread, greens, nuts, red meat, etc.;
- Vitamin D: butter, liver;
- group C vitamins: sauerkraut, wild rose, blackcurrant, sweet varieties of pepper.
NOTE! It is impossible to completely cure MS with vitamins. But they are necessary for the proper course of metabolic processes.
This is especially important under adverse circumstances, when vitamins are consumed very quickly. During infection, during exacerbations of MS, during emotional and physical upheavals.
If it is not possible to constantly consume foods rich in vitamins, dietary supplements will come to the rescue.
The main thing is the B vitamins, especially B12, they are involved in the synthesis of myelin, prevent the breakdown of axonal formations. The course of this vitamin or cyanocobalamin can only be recommended by a doctor. And the course is long. About 6 months. But it is a good prevention of MS.
Causes of the disease
Until now, the exact cause of the disease has not been clarified. It is only known that the impetus for the disease is the malfunction of the immune system. There is no other reason. Neither age nor level uric acid, only indirectly stress and bad habits. They cannot be main reason exacerbations, but in combination with other provoking factors - they can.
The reason is a malfunction of the immune system. Normally, both the brain and spinal cord are protected by the blood-brain barrier. If we briefly talk about the essence of the disease, during an exacerbation of the disease, lymphocytes and immune cells penetrate into the brain and spinal cord.
And instead of attacking, for example, bacteria, they fight…. with your cells own body. More precisely, they produce antibodies that attack myelin cells. nervous system.
Is there some more a number of factors that can trigger the onset of the disease:
- a person may be genetically predisposed to the disease;
- the patient experienced severe stress;
- he lacks vitamin D;
- he has various viral diseases and/or bacterial.
REFERENCE! Most often, this disease affects young people and middle-aged people (from 15 to 40 years old), but sometimes it also occurs in very young children who are 2 years old and older. But those who are 50 or older have a lower risk of getting MS.
The disease is not so rare. This disease is the second in the list of causes of neurological disability in young people. In women, the disease occurs 2-3 times more often than in men. But at the same time, they usually tolerate it easier. The disease rarely has a significant impact on life expectancy.
Symptoms
In multiple sclerosis, there are the following symptoms(at different people different manifestations can occur, in many they can be combined):
- the patient complains of fatigue;
- depression and/or unstable mood;
- various cognitive impairments;
- various visual impairments; or ask your question, then you can do it perfectly is free in comments.
And if you have a question that goes beyond the scope of this topic, use the button Ask a Question above.
Multiple sclerosis (MS) is a chronic autoimmune disease nervous system, in which the myelin sheath covering the nerve fibers of the brain and spinal cord, as a result of which the patency of signals in the CNS is disturbed. The disease is expressed by different number and intensity of neurological symptoms, while the course of the disease and the degree of CNS damage in each individual patient is almost impossible to predict. The consequences could be various forms violations of motor, cognitive and psychological functions, up to partial or complete disability. Currently, a complete cure for multiple sclerosis is very rare, but the emergence of new generation drugs gives hope for a greater chance of recovery than was the case in the past.
Early diagnosis of multiple sclerosis is of paramount importance, as it allows you to stop the development of the disease, and prevent the deterioration of the patient's health. Over the past ten years, the approach to the treatment of multiple sclerosis has undergone significant changes. If earlier the goal of multiple sclerosis therapy was to reduce the number of neurological seizures, today the success of treatment is considered to be the selection of such drugs that will eliminate all the symptoms of multiple sclerosis: both attacks of the disease and focal lesions of the myelin sheaths, which are determined on MRI images.
The success achieved today in the treatment of multiple sclerosis is due both to increased awareness and the emergence of new generation drugs. The first such drug was Tysabri (Natalizumab), which was able to significantly reduce the manifestations of this disease.
New drugs for the treatment of multiple sclerosis
"Dimethyl fumarate» (DMF) fumaric acid dimethyl ester. The new generation drug was originally intended for the treatment severe forms psoriasis, but after successfully completed three stages trials confirming that the drug effectively protects cells of the nervous system from the destructive effects of the inflammatory autoimmune process, has been approved for the treatment of multiple sclerosis.
« Fingolimod» - an immunosuppressive drug that binds to the SlP receptors of lymphocytes and thereby prevents the release of lymphocytes from lymph nodes. Thus, there is a redistribution of lymphocytes in the body: their total does not decrease, but the entry into the central nervous system decreases, and, as a result, inflammation and the degree of damage to the tissues of the central nervous system decrease.
« Alemtuzumab» — long time this drug has been used to treat chronic lymphocytic leukemia and T-cell lymphoma, but has been found to be effective in multiple sclerosis as well. Alemtuzumab selectively destroys mature lymphocytes involved in the immune response in multiple sclerosis by attaching to the CD52 antibody that is on their surface. After the series clinical trials The FDA approved the use of the drug for MS.
« Daclizumab" is an immunosuppressive preparation of humanized monoclonal antibodies used in complex therapy for the prevention of acute rejection after kidney transplantation. The drug blocks the action of interleukin-2 and inhibits the activation of lymphocytes, which inhibits the immune response of transplant rejection. Preliminary data from clinical studies give great hope for the use of the drug in the treatment of multiple sclerosis.
LINGO-1- a monoclonal antibody specific for the LINGO-1 protein, which restores the damaged myelin sheath of the nerve fibers of the brain and spinal cord. In the treatment of multiple sclerosis, there is a need to restore the tissues of the central nervous system that have been damaged as a result of the disease. For this purpose, the drug LINGO-1 was created, which promotes the regeneration of the myelin sheath and the growth of new cells. Currently located on last stage clinical research.
What is expected in the treatment of multiple sclerosis
The results of recent studies have shown the high efficiency of new generation drugs. Modern drugs for the treatment of multiple sclerosis can eliminate the manifestations of the disease and return the patient to normal life as fully as possible. Of particular importance is also a smaller number of side effects, the risk of which is determined using a blood test. It should be noted that these drugs are used in relapsing-remitting multiple sclerosis, which accounts for about 85% of all cases of the disease.
A special place is occupied by the search for drugs for the treatment of progressive multiple sclerosis, the possibilities of therapy for which are currently limited. Without suitable treatment the condition of such patients rapidly worsens up to complete disability. Scientists are developing a drug to treat this type of multiple sclerosis, and it is hoped that in the near future there will be a drug that will make a breakthrough in the treatment of this disease.
Clemastine (Tavegil), an over-the-counter allergy drug, can increase the speed of nerve impulses in the brains of people with multiple sclerosis.
In a recent phase II clinical trial, clemastine tablets have been shown to significantly improve nervous system function in multiple sclerosis by repairing the myelin sheath of damaged neurons. This is reported by the authoritative publication The Lancet.
Multiple sclerosis (MS) is an autoimmune disease that affects more than 2.3 million people worldwide. The disease affects the myelin sheath around nerve cells, disrupting the ability to conduct electrical signals and dissociating the nervous structures of the brain.
As the nerve fibers demyelinate, they develop typical symptoms MS: impaired gait and coordination of movements, frequent falls due to loss of balance.
Current therapy focuses on preventing further damage to nerve cells. immune system, but no one has ever learned how to repair myelin sheaths.
Clemastine fumarate appears to be the first ever drug, which is able to reverse the effects of multiple sclerosis (MS). According to scientists, that day will come very soon.
New drug for multiple sclerosis?
In 2014, research conducted by Professor Jonah Chen of the University of California at San Francisco (USA) made clemastine the #1 candidate for the treatment of multiple sclerosis. Because of the enormous importance of the results, the drug moved quickly to clinical trials. Last week, the results of a Phase II clinical trial of clemastine fumarate in patients with multiple sclerosis shocked the medical community.
Clemastine fumarate was first adopted as a antihistamine in the 70s of the last century. In the United States, it was approved in 1977 and has been OTC drug status since 1993. In countries former USSR well known under the brand name tavegil.
“The potential of clemastine for the treatment of multiple sclerosis is amazing. To the best of our knowledge, this is the first drug to reverse demyelination in MS. This is not yet a victory over the disease, but the first step towards restoring brain function for millions of people, a chance to regain a decent quality of life and independence,” says project leader Dr. Ari Green.
Clinical Trial Details
American scientists tested clemastine fumarate on 50 volunteers with severe multiple sclerosis. The duration of the disease was at least 5 months. Since vision is the first to be hit by MS, the researchers measured what are called visual evoked potentials (VEPs). It is a well-established method for evaluating neural connections.
The measurement of evoked potentials was carried out by the classical method: participants observed flickering pictures on a computer monitor, and electrodes over the visual areas of the brain helped to estimate how long the nerve impulse travels from the eye to the cortical visual centers.
For 90 days, half of the participants received clemastine and the other half received a placebo. Then the groups switched places: the placebo group was given the real drug, and vice versa. The study was double-blind: neither participants nor researchers knew who was receiving clemastine.
“Colleagues thought we were crazy to start this kind of research. They believed that in newly diagnosed cases, clemastine would not work. But my intuition told me that fresh injuries myelin, the likelihood of recovery will be maximum,” Chen admits.
According to the professor, allergy pills have been effective even in advanced cases of multiple sclerosis, when the disease has exhausted patients for many years.
How to evaluate myelin repair
V this study scientists have not been able to measure myelin regrowth with MRI. The reason is the imperfection of visualization technologies. “We still do not have imaging methods that reliably detect the repair of the myelin sheaths of neurons. Despite this, VEPs provide us with clear evidence of myelination. There simply cannot be another explanation for the results,” explains the professor.
In addition, in vitro studies on human cells have shown that clemastine stimulates the activity of oligodendrocytes, myelin-producing cells of the central nervous system.
Konstantin Mokanov
Multiple sclerosis is a chronic demyelinating disease of the nervous system. It proceeds with periods of exacerbation and remission. After each exacerbation, disturbances of the nervous system remain, over time, a person becomes disabled. In the Yusupov hospital, all modern methods treatment of MS to prevent the progression of demyelination.
The treatment of multiple sclerosis is the most urgent problem of modern neurology. Due to the variability of symptoms and their variability over a short period of time, an individual approach to the choice of treatment regimen and doses of drugs is necessary. This approach of the neurologists of the Yusupov hospital allows you to stop the development of the disease and reduce the number of exacerbations.
Treatment of multiple sclerosis
The strategic goal of the treatment of multiple sclerosis is to prevent the growth of disability. Its main areas are relief and prevention of exacerbations, leveling of neurological disorders.
- treatment of exacerbations;
- immunomodulatory therapy;
- the use of immunosuppressive drugs.
In case of exacerbation of multiple sclerosis, the patient is hospitalized in the inpatient department of the Yusupov hospital, where he is provided with a service high level. He undergoes an examination using modern diagnostic devices and receives treatment with original drugs with the selection of doses depending on the severity of the symptoms and the effectiveness of the therapy.
The main principle of therapy that modulates the course of multiple sclerosis, the neurologists of the Yusupov hospital consider its early appointment in order to reduce the frequency and prevent exacerbations, stabilize the patient's condition and slow down disability.
We pay special attention symptomatic therapy. It is used to reduce the severity or compensate for residual neurological symptoms, prevention of complications, the longest possible preservation of social activity, ability to work and the ability to serve themselves independently. For this purpose, antioxidants, neurotrophic and neurometabolic drugs, cholinergics are used.
In the Yusupov hospital, doctors at all stages of the disease carry out the rehabilitation of patients suffering from multiple sclerosis. To restore lost functions, innovative physiotherapy techniques, acupuncture, physiotherapy. After treatment, many patients return to a full life.
Call for a consultation with a neurologist specializing in the treatment of multiple sclerosis. The doctor-consultant of the Yusupov hospital is in the feedback mode and will answer all questions.
Bibliography
- ICD-10 ( International classification diseases)
- Yusupov hospital
- Gusev E.I., Demina T.L. Multiple sclerosis // Consilium Medicum: 2000. - No. 2.
- Jeremy Taylor. Health by Darwin: Why we get sick and how it relates to evolution = Jeremy Taylor “Body by Darwin: How Evolution Shapes Our Health and Transforms Medicine”. - M.: Alpina Publisher, 2016. - 333 p.
- A.N. Boyko, O.O. Favorova // Molecular. biology. 1995. - V.29, No. 4. -p.727-749.
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