Leading Neurologist Highlights How Multiple Sclerosis (MS) Treatment Is Improving Daily Life For Patients

“Now with the new diagnostic criteria, we can actually diagnose someone as having multiple sclerosis before they’ve even had a symptom, just based on the imaging. What that indicates is we could sort of, theoretically prevent clinical MS from ever appearing,” Dr. Sicotte says.

“If you can diagnose someone at that level, at that stage, put them on a disease-modifying therapy, and then they would, theoretically, never have symptoms. We would be preventing them from having any symptoms or any disability,” she adds.

Treating MS early can help prevent attacks that may cause lasting symptoms, making prevention of relapses a key goal of care.

Treatments can be injectable, oral, or infusion medications.

Understanding Disease Progression

Although researchers do not fully understand all the factors that drive MS progression, certain genetic traits appear to increase the likelihood of more aggressive disease.

Still, with earlier diagnosis and today’s effective treatments, many patients are achieving favorable long-term outcomes, Dr. Sicotte notes.

When MS is diagnosed early, patients can “get put on a very, very effective disease-modifying therapy, and then they just get on with their lives,” she explains. “I definitely have patients who I see … saying to me, ‘I really forget most of the time that I’m living with MS.’ So to me, that’s so amazing and wonderful to hear.”

The Role Age Plays in MS Progression

Dr. Sicotte also highlights that the biggest risk for MS progression is simply age, though healthy living habits can also have an impact.

While some risk factors cannot be changed, patients can focus on healthy habits such as regular exercise, balanced nutrition, sufficient sleep, and preventing or managing chronic illnesses like diabetes and high blood pressure, Dr. Sicotte notes.

“Folks who can keep themselves relatively healthy, that seems to be protection for this progression,” she explains, adding that scientists are currently studying how aging affects the immune system and contributes to MS progression.

The research could uncover new treatment approaches not only for MS, but also for other neurological diseases such as ALS, Alzheimer’s, and Parkinson’s.

Quality of Life Is Improving

While MS is still a very serious condition, many people lead very full lives.

“People with MS are just living their lives,” Dr. Sicotte says. “They’re having families, they’re working, they’re traveling, you know, they’re doing everything that they would want to do in their life. And thankfully, that is much more common these days.

“It’s very common that we see people just thrive and do well. That said, there are definitely patients who, even despite being on good treatments, will have worsening over time.”

She notes that in more advanced cases of MS, patients may experience substantial mobility limitations, with some relying on wheelchairs for daily support. A small percentage require extensive caregiving assistance.

“Our big challenge right now is better understanding why some people seem to do great and other people will have this relentless, worsening MS,” Dr. Sicotte adds, noting that a key factor is identifying MS early and starting treatment before major damage occurs.

She notes that, because aging is a major driver of progression, over time people living with MS long-term may be more likely to experience this stage of the disease.

Living With Multiple Sclerosis

Multiple sclerosis causes the immune system to attack cells that form the protective sheath that covers nerve fibers in the spinal cord. The disruption leads to communication problems between the brain and the rest of the body.

Once the protective barrier is damaged, the spinal cord struggles to communicate with the body’s arms, legs, and other parts to function normally.

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There is no cure for MS currently, but there are methods to manage symptoms.

Common tools patients use to improve their quality of life include wheelchairs, canes, leg braces, and disease-modifying therapies (DMTs).

A study in American Family Physician found that DMTs “have been shown to slow disease progression and disability; options include injectable agents, infusions, and oral medications targeting different sites in the inflammatory pathway.”

Autologous hematopoietic stem cell transplantation (AHSCT), also called bone marrow transplantation, with autologous meaning a patient’s own cells, can help “reset the immune system” for patients with multiple sclerosis, according to research published in Frontiers in Neurology.

Several studies and clinical trials using AHSCT have shown promise, and additional research published by NEJM Journal Watch says that AHSCT helps MS patients reduce relapses better than other forms of MS treatment.

There are four main types of multiple sclerosis:

• Clinically isolated syndrome (CIS): This is when an individual experiences a single neurological episode lasting 24 hours or less. CIS is what MS is diagnosed as until there is a second episode.
• Relapsing-remitting MS (RRMS): The most common MS among the million people battling the disease in the U.S., RRMS is marked by sudden flare-ups, new symptoms, or worsening of symptoms and cognitive function. The condition will then go into remission for some time before reemerging with no known warning signs.
• Primary progressive MS (PPMS): These individuals have no flare-ups or remission, just a steady decline with progressively worse symptoms and an increasing loss of cognitive and body functions.
• Secondary progressive MS (SPMS): This is an almost transitional form of MS that progresses from RRMS to PPMS.

Questions To Ask Your Doctor

If you are diagnosed with MS or are concerned you have the chronic disease due to symptoms you’re experiencing, consider asking your doctor the following questions.

• Which treatment option do you recommend to manage my symptoms?
• Are there any potential side effects of MS treatment?
• What if the treatment to manage symptoms doesn’t work?
• Will exercise or therapy help my symptoms?
• Are there any MS support groups you recommend to help me cope?

Contributing: SurvivorNet Staff

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