Multiple sclerosis (MS) is an autoimmune disease of the brain and nerves that\u2019s still considered incurable. However, MS may be put into remission, and different diets and complementary approaches are promoted to do so. In this post, we review conventional treatments and complementary approaches to MS.<\/p>\n
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Disclaimer: This post is not a recommendation for any particular type of MS treatment. Make sure to discuss your options with your personal doctor; none of the complementary approaches described below should be used to replace medical treatment. The goal of this post is simply to inform our readers about the science and evidence behind some potential complementary approaches to MS, which may or may not be effective.<\/em><\/p>\n Although there is no universal cure<\/strong> for MS, several therapies have proven effective in preventing the progression and relapses of the disease. There are no known therapies that promote the regeneration of these deficits because MS damages neurons in the brain [R<\/a>].<\/p>\n Spontaneous recovery is rare if the damage to the neurons has progressed longer than 6 months [R<\/a>].<\/p>\n MS\u2019s long-term disability progresses slowly over many years. As a result, many treatments mitigate the short-term symptoms of the disease [R<\/a>].<\/p>\n A patient with MS (relapsing-remitting MS or primary progressive MS) will commonly face relapses or attacks, which are flare-ups of new or recurring symptoms. Administration of high doses of glucocorticoids<\/strong> (methylprednisolone<\/a>) or corticosteroids<\/strong> is the current routine therapy for acute relapses [R<\/a>, R<\/a>].<\/p>\n The advantages of using glucocorticoids include rapid functional recovery<\/strong> in patients with acute attacks [R<\/a>].<\/p>\n Administration of intravenous glucocorticoid can lead to potential side effects such as reddening of the face, ankle swelling<\/strong>, and a metallic taste<\/strong> in the mouth. Oral administration of glucocorticoids has more side effects including disturbed sleep, mood changes<\/strong>, and stomach problems<\/strong> [R<\/a>].<\/p>\n Also, glucocorticoids only mitigate the short-term symptoms of MS without dealing with the long-term effects [R<\/a>, R<\/a>].<\/p>\n High doses of glucocorticoids will not<\/strong> affect long-term disease improvement because of the treatment\u2019s limited effects on MS lesions in the brain. The irreversible damages are not being regenerated [R<\/a>].<\/p>\n Glucocorticoids may also have detrimental effects<\/strong> on<\/strong> bone density<\/strong>, increasing the risk of bone fracture <\/strong>[R<\/a>].<\/p>\n Disease-modifying therapies<\/strong> (DMTs) were created and approved to manage the long-term effects of MS by slowing the natural course of the disease. Clinical studies have demonstrated that disease-modifying therapies (interferon beta<\/a>, glatiramer acetate) have anti-inflammatory effects and slows the progression in relapsing-remitting multiple sclerosis (RRMS) patients [R<\/a>].<\/p>\n Some disease-modifying therapies (IFNb-1a) promote nerve growth factors (NGF) to support the repair of neurological damage, leading to a decrease in lesion activities and disease relapse rates [R<\/a>].<\/p>\n Disease-modifying treatments (IFNb, glatiramer acetate) also reduce the attack rates or relapses in relapsing-remitting multiple sclerosis patients and is effective at mitigating those attacks in the earlier stages [R<\/a>].<\/p>\n Some common adverse side effects of disease-modifying therapies (IFNb, glatiramer acetate) include bruising, redness of the skin, pain, irritation, skin lesions, swelling<\/strong>, and sometimes cell death<\/strong> (necrosis) [R<\/a>, R<\/a>].<\/p>\n Other rare potential side effects of disease-modifying therapies (IFNb) include immune system problems (psoriasis), insomnia, hearing loss, hair loss (alopecia), and in more severe and rare cases, liver damage [R<\/a>, R<\/a>].<\/p>\n Primary progressive multiple sclerosis<\/strong> (PPMS) is characterized by the progressive worsening of neurologic functioning from the onset of the disease, usually targeting one part of the brain (usually the spinal cord). As the disease progresses, the symptoms increases.<\/p>\n Most of the disease-modifying therapy drugs (IFNb, glatiramer acetate) were approved and effective for relapsing-remitting MS. Most of these drugs are not effective<\/strong> against primary progressive MS [R<\/a>, R<\/a>].<\/p>\n Primary progressive MS is problematic and tricky because patients do not respond to currently available treatments. About 10%<\/strong> of the patients have primary progressive MS<\/strong>, which accumulates neurological deterioration without relapses [R<\/a>].<\/p>\n On March 28, 2017, the FDA approved ocrelizumab (produced by Hoffmann-La Roche) as the first treatment for primary progressive MS [R<\/a>, R<\/a>].<\/p>\n Ocrelizumab is a biologic immunosuppressive drug (anti-CD20 monoclonal antibody) that binds to immune cells (B cells) and prevents those cells from exerting harmful effects on the body [R<\/a>].<\/p>\n During clinical trials, ocrelizumab has reduced relapse rates by 46%-47%<\/strong> and disability progression<\/strong> by 40%<\/strong>. Ocrelizumab also incredibly reduced inflammation and decreased the progression of lesions in the brain [R<\/a>].<\/p>\n Ocrelizumab is contraindicated in patients with hepatitis B or allergic reactions to ocrelizumab. It can increase the risk for respiratory tract infections, viral infections of the brain<\/strong> (Progressive Multifocal Leukoencephalopathy), or breast cancer<\/strong> [R<\/a>].<\/p>\n Ocrelizumab is a relatively new, approved drug and the FDA required Hoffmann-La Roche to continue post-marketing surveillance (phase IV trials) and report any risks, side effects, or adverse effects associated with the drug [R<\/a>].<\/p>\n<\/a>Conventional MS Treatment<\/strong><\/span><\/h2>\n
<\/a>1) Glucocorticoids<\/strong><\/span><\/h3>\n
<\/a>Limitations<\/strong><\/h4>\n
<\/a>2) Disease-Modifying Therapies<\/strong><\/span><\/h3>\n
<\/a>Limitations<\/strong><\/h4>\n
<\/a>3) Ocrelizumab<\/strong><\/span><\/h3>\n
<\/a>Limitations and Contraindications<\/strong><\/h4>\n