Recently some doctors have announced that they have discovered a successful way to contain multiple sclerosis. However, the treatment is so risky that it cannot be extensively used.
In Canada, they have treated 24 multiple sclerosis (MS) with potent chemotherapy, essentially destroying their immune systems before a stem cell transplant.
The combination of treatment stopped the degeneration and the development of new brain lesions in 23 patients. This happened without needing chronic medication.
Eight out of the 23 patients had sustained development in their disability almost 8 years after treatment. Unfortunately, one of the 24 participants died from sepsis and liver failure. These were caused by the chemotherapy.
This is the very first treatment to deliver this level of neurological recovery or disease control from multiple sclerosis. Sadly, treatment-related risks restrict its extensive application.
There are 2.3 million people worldwide who are affected by multiple sclerosis. MS is a potentially disabling condition of the spinal cord and the brain. When a person has MS, his immune system mistakenly attacks the defensive sheath or myelin that covers the nerve fibers and causes communication issues between his brain and the rest of his body.
In the long run, this condition can lead to the deterioration and permanent damage of the nerves.
The symptoms vary from blurred vision to severe fatigue to partial or total paralysis. Early in the MS, people usually experience brief episodes of worsening symptoms along with active inflammation in the brain or relapses, whereas later, disease progression is unavoidable.
The signs and symptoms of multiple sclerosis differ widely and rely on the amount of nerve damage and the affected nerves. Some patients with severe multiple sclerosis may lose the capacity to walk by themselves or at all, while others may experience lengthy periods of remission without new symptoms.
Until today, there is no cure for multiple sclerosis or MS. But, there are treatments that can help speed recovery from the attacks. These alter the course of the disease and control symptoms.
People with multiple sclerosis may suffer with vision, balance and movement problems. Sadly, this is a lifetime and lasting condition. In some cases, symptoms of multiple sclerosis come and go in phases. These phases are called relapses. In other cases, they gradually worsen over time.
In many specialized clinics, a lighter form of treatment is used. It is called aHSCT or autologous haematopoietic stem cell transplantation or, on a small number of patients. This involves haematopoietic stem cell transplants, which are immature cells present in the bone marrow. These cells become blood and immune cells.
MS patients have their immune systems suppressed by chemotherapy after the stem cells are collected from the bone marrow. This must happen before the stem cells are infused into the patient’s bloodstream.
For a recent research, the team incorporated even stronger chemotherapy to completely destruct, instead of suppressing the immune system.
The 24 patients aged 18 to 50 were enrolled in the phase II clinical trial. The clinical trial is specially designed to gauge whether the treatment is effective. All of them had an “aggressive” form of MS, where their disabilities ranging from “moderate” to being incapable of walking approximately a hundred steps unaided.
Fortunately, in the 23 patients who survived the treatment, there were no relapses for the entire period that they were being studied – between 4 and 13 years.
Their MRI scan results revealed no new disease activity. The initial MRI scans of 24 multiple sclerosis patients showed 93 brain lesions, and after the treatment only one out of 327 scans demonstrated a new lesion.
After three years, 6 patients were able to ease or discontinue their disability insurance, and go back to school or work.
There are other treatments to manage the symptoms. These treatments are usually focused on speeding the recovery period from attacks, managing multiple sclerosis and slowing its progression. Some patients have mild symptoms that no amount of treatment is needed.
Corticosteroids and plasmapheresis are the most popular treatment for multiple sclerosis attacks. Corticosteroids like intravenous methylprednisolone and oral prednisone are prescribed to ease nerve inflammation. Side effects of these treatments may include mood swings, insomnia, fluid retention and increased blood pressure.
In plasmapheresis or plasma exchange, the liquid portion of the body (plasma) is removed from the blood cells. The blood cells are then combined with a protein solution, called albumin, and put back into the body. Plasmapheresis is a great option if the symptoms are new, critical and have not responded to steroids.
In addition, there are MS treatments to modify progression. There are no therapies that have shown benefit for slowing the progression of this condition. Numerous diseases-modifying therapies are available for relapsing-remitting multiple sclerosis.
The treatment options for relapsing-remitting multiple sclerosis include beta interferons (injected under the skin or into the muscle), glatiramer acetate or Copaxone (injected under the skin that helps block immune system’s attack on myelin), dimethyl fumarate or tecfidera (oral medication that reduces relapses).
In addition, some people can take fingolimo or gilenya (oral medication that lowers the relapse rate). Some patients opt for natalizumab or tysabril (blocks the movement of the potentially destructive immune cells from the bloodstream to the central nervous system) or alemtuzamab (lemtrada) that helps decrease relapses of multiple sclerosis by targeting the protein on the immune cells’ surface. Mitoxantrone is another MS drug, but this can be dangerous to the heart and is related to blood cancer development.
Some patients opt to undergo physical or occupational therapy that involves stretching and strengthening exercises. Many of those who experience painful muscle spasms, especially in the legs use muscle relaxants like tizanidine (zanaflex) and baclofen (lioresal).
Many multiple sclerosis patients use a variety of alternative or complementary treatments. These deal with muscle pain, fatigue and other symptoms. Meditation, massaging, exercise, yoga, acupuncture and relaxation techniques may help improve overall physical and mental well-being, but there are some studies to support their significance in managing MS symptoms.
The American Academy of Neurology released guidelines regarding the use of an oral cannabis extract for muscle pain and spasticity. This does not suggest the use of herbal supplements like Gingko biloba.