Multiple Sclerosis (MS) is an autoimmune disease that attacks the myelin sheath, the material that surrounds and protects your nerve cells, affecting your brain and your spinal cord. Approximately 2 million people worldwide have MS.
Autoimmune disorders occur when the immune system malfunctions and attacks the body’s own tissues and organs, in this case tissues of the nervous system.
Multiple sclerosis usually begins in early adulthood, between ages 20 and 40. The symptoms vary widely, and affected individuals can experience one or more effects of nervous system damage.
- Fatigue which can interfere with the ability to function at work or home.
- Difficulty walking related to weakness, muscle spasms, and loss of balance.
- Numbness or tingling of the face, body or limbs.
- Spasticity or feelings of stiffness and involuntary muscle spasms in arms and legs.
- Weakness due to nerve damage or deconditioning of unused muscles.
- Vision problems is often the first symptom and is characterized by blurred vision, poor contrast of color vision, and pain on eye movement.
- Dizziness and vertigo can make people with MS feel off-balance or lightheaded.
- Bladder problems occur in 80% or people with MS.
- Sexual problems are very common among people with MS. Damage to the central nervous system, plus fatigue, spasticity, and psychological factors can affect sexual responses.
- Bowel problems including constipation and loss of bowel control are common symptoms.
- Pain is common in MS and half of patients in one study had chronic pain.
- Cognitive changes are apparent in more than 50% of people with MS. These changes affect the ability to process information and perceive the environment around you, learn and remember new information, problem solve, and focus.
- Emotional changes including depression, mood swings, irritability, and episodes of uncontrollable laughing and crying, can be the result of the stress of living with MS, or from neurological changes.
- Clinical depression, the most severe form of depression, is more common in people with MS than any other group of people, including the general population.
There is not ONE test that diagnoses MS. Oftentimes, your doctor will rule out other diseases before determining the you have MS. Blood tests, MRI, lumbar puncture for spinal fluid, and evoked potential tests, which record the electrical signals produced by your nervous system in response to stimuli, are used diagnose.
Now for the good news:
A few days ago, the FDA approved a new medication that is a first to treat the most common form of MS called relapsing-remitting MS (RRMS), but it also has been approved to treat a rare form of MS. Primary progressive MS (PPMS) is an especially debilitating form of MS where the disease steadily worsens rather than having periods of remission like RRMS.
Ocrevus [Ocrelizumab] from Genentech is a type of drug known as a monoclonal antibody, which targets a specific type of immune cell thought to be involved with nerve and myelin cell damage. Ocrevus was given a “breakthrough therapy designation” last year because of its ability to treat PPMS.
In clinical trials, patients received 600 mg intravenously every 6 months. “An infusion every 6 months makes it very convenient, so people don’t have to take it on a more regular basis like injectables or pills,” said Clyde E. Markowitz, MD, director of the Multiple Sclerosis Center at the University of Pennsylvania and the principal investigator on the primary progressive trial for Ocrelizumab.
In clinical trials:
- Ocrevus helped to slow the progression of PPMS by 24%. That means that patients who were taking the drug were more stable.
- In patients with RRMS, there was a 46% decrease in annual relapse rates.Doctors say patients on average relapse once a year without treatment.
- 48% of patients in the relapsing-remitting MS trial had no relapses, no worsening of neurological symptoms, and no new brain lesions seen on MRI scans.
“The results for the relapsing trial were more impressive, given that they were tested against an already approved therapy, but progressive disease is harder to study because it occurs so slowly,” he says. “To see a significant benefit would take years, and this was only approximately a 2-year trial”, says Markowitz.
According to the FDA, Ocrevus should not be used by patients with hepatitis B or other active infections. It may also increase the chance of cancers, particularly breast cancer.
The annual cost of Ocrevus could range from $60,000 to $70,000 per year before insurance. PPMS patients may have an easier time getting approval from their insurance company since it is the only medication for that form of MS and there are many treatment options for RRMS.
Ocrevus will be available in the US with the next two weeks.
Want to help?
Get involved and help raise awareness and money for Multiple Sclerosis. The MS Walk in Wilmington will be held on May 6, 2017 at Greenfield Lake. For more information, or to sign up, click here.