Treatment for Advanced MS
You may have had a progressive form of MS right from the start, or perhaps you were initially diagnosed with a relapsing-remitting course that has become steadily progressive. In either case, there are few treatment options available right now for progressive forms of MS. And while that is discouraging, some of the drugs in the pipeline look promising. In the meantime, though, your neurologist is likely to have a few tricks up his sleeve, and with effective symptom management and support, you can maintain a high quality of life.
The six disease-modifying drugs available for MS target those who experience relapses, including relapsing-remitting, and some types of secondary progressive MS. Those with primary progressive MS and secondary progressive MS without relapses may not be appropriate candidates for these therapies. The good news is that your doctor may recommend some other options including the following.
This chemotherapy drug is often prescribed for folks with secondary progressive MS, with or without relapses. It has a lifetime dose limit because of heart complications, but it's been shown to slow down or reduce the progression of disability in some patients. Novantrone is not FDA-approved for people with primary progressive MS.
Do more men or women get PPMS?
Twice as many women are diagnosed with RRMS than men, whereas PPMS is divided equally between the sexes. Some sources report a slight tendency toward more men than women being diagnosed with this form of MS. The onset of PPMS is generally after age thirty-five, with many people being diagnosed in their forties or fifties.
Immunosuppressants have been used to suppress the immune system in people with MS who are not experiencing relapses. Chemotherapy drugs such as Imuran (azathioprine), Cytoxan (cyclophosphamide), and methotrexate can be used and seem to be effective in altering the course of the disease for some people.
Treatments on the Horizon
Researchers around the world are striving to discover better diagnostic criteria and possible treatment options for progressive MS. Research may unveil a line of MS drugs and therapies that repair and regenerate lost myelin and nerve fibers (axons). The drugs may have the potential to restore function, which is an important goal in MS research. Some agents are showing this type of action in animal studies, but the transition from animal studies to human trials can be lengthy and difficult.
Neuroprotection is another area of interest for the treatment of all types of MS. This type of treatment would potentially protect the central nervous system from damage caused by an attack from the body's immune-system cells. The hope is that nerves and myelin would remain more intact, and patients would have fewer symptoms.
Researchers hope it will be just a matter of time before individuals with PPMS have access to new disease-modifying therapies.