Multiple sclerosis (MS) is a chronic disease causing areas of inflammation in the brain and spinal cord. It is a common cause of disability in young adults.
The symptoms of MS depend on which areas are affected. Symptoms may include marked tiredness, impaired vision, loss of balance and coordination, muscle spasms, bladder and bowel problems and paralysis.
MS usually begins between 20 and 40 years and runs an unpredictable course. Most patients have a ‘relapsing-remitting’ illness, with symptoms suddenly appearing for days or weeks and then partly or fully settling. There is also a ‘progressive’ form with more gradual deterioration.
MS can have a devastating effect on independence and quality of life. However, some patients have only minor symptoms and the majority do not become severely disabled.
Drug treatment for MS
Most acute attacks of MS do not need treatment. Intravenous cortisone injections can speed recovery in more severe episodes.
Several drugs (interferon-beta, glatiramer acetate) prevent attacks and may slow the progress of the disease. They are given by regular self-injection and reduce the rate of further flareups by about one third.
A new medication, natalizumab, is the most effective treatment to date. It cuts the relapse rate by two thirds and slows disease progression by nearly half. It is given by IV infusion every 4 weeks and is expected to be available on the PBS in early 2008.
Although generally well tolerated, it has been associated with a few cases of PML (progressive multifocal leucoencephalopathy), a rare and sometimes fatal brain infection, usually in people with weak immune systems.