Before 1993, people with multiple sclerosis had limited options for treatment. Today, there are 16 disease-modifying treatments approved by the Food and Drug Administration (FDA).
I knew about multiple sclerosis, or MS, when I was very young. My grandmother had it. She was diagnosed in the ’60s when she had four young children. I only knew my grandmother using a wheelchair, and I remember her makeshift devices that helped her complete daily tasks. She had several layers of napkins wrapped around a pen with a rubber band so she could hold onto it to scribble notes. She had a “reacher” with a claw on the end so she could grab items from the cabinet. She was the only person I knew with MS, so I assumed that was how MS affected everyone with the disease.
When I got older, I met other people living with MS. Many were working full-time jobs and raising their families. They were driving cars and walking down the hallway.
So why did MS cause my grandmother to have to use a wheelchair, but allows others to move around freely? I spoke with Robin Tillett, R.N., MSCN, patient navigator for Norton Neuroscience Institute, and Yvette Cabrera-Rojas, director for Norton Neuroscience Institute Resource Center, to find out.
Norton Neuroscience Institute
Recognized as a Center for Comprehensive MS Care by the National Multiple Sclerosis Society
How has MS treatment changed over the last 30 or 40 years?
Prior to 1993, no FDA-approved treatments existed for MS. Before treatment was available, MS patients would see their doctor when they had symptoms or attacks and be treated for those symptoms. It was a reactive approach. When the first medication became available in 1993, MS patients had to be chosen in a lottery to receive it.
Today, there are 16 FDA-approved treatments that slow the progression of the disease, decrease the number of attacks and the severity of the attacks, and delay disability. Once diagnosed, treatment starts in order to prevent disease progression.
Years ago, patients with MS were told not to exercise. Because exercise increases body temperature, doctors thought it made MS symptoms worse and made the disease worse. Now we know exercise is very beneficial to people with MS. Exercise decreases levels of disability, improves mental health and helps with depression, and it results in fewer MS relapses.
MS treatment also focuses on overall well-being. This includes diet, exercise, maintaining a healthy body mass index (BMI), smoking cessation and reducing stress with activities like yoga and tai chi.
Today, MS patients who use a disease modifying therapy and who take actions to improve their overall health and well-being may not experience any level of disability for 20 or 25 years or more. Some people with an aggressive form of MS may not respond to therapy, but these cases are in the minority.
What advancements in MS treatment are being studied or researched today?
There are many oral and intravenous therapies being researched. One of the most promising advancements is DNA testing that helps determine what medications will be most effective for MS patients. Some patients don’t respond to certain drug classes, so knowing which drugs will work best for each patient will improve treatment. Other areas of research include myelin repair to repair previous damage to the nerves and stem cell research for MS which is in the early stages.