MS 5 Flashcards
Medications for MS do this:
- modify disease course
- treat attacks
- manage symptoms
How many disease-modifying agents approved by the FDA?
14
Types of disease-modifying agents that can be used to treat MS
- self-injectables
- oral
- IV
How many self-injectables are available to treat MS?
8
How many oral drugs are available to treat MS?
3
How many IV drugs are available to treat MS?
3
Drug type: Natalizumab (Tysabri)
IV
Drug type: Teriflunomide (Aubagio)
Oral
Drug type: Fingolimod (Gilenya)
Oral
Drug type: Interferon beta 1-a (Avonex and Rebif)
Self-injectable
Drug type: Interferon beta 1-b (Betaseron and Extavia)
Self-injectable
Drug type: Daclizumab (Zinbryta)
Self-injectable
Drug type: Dimethyl fumarate (Tecfidera)
Oral
Drug type: Mitoxantrone (Novantrone)
IV
Drug type: Glatiramer acetate (Copaxone and Glatopa)
Self-injectable
Drug type: Peginterferon beta 1-a (Plegridy)
Self-injectable
Drug type: Alemtuzumab (Lemtrada)
IV
Why is early tx so early with MS?
Neuroinflammation and neurodegeneration occur early in the disease course
Individuals with first clinical event with MRI findings consistent with MS have:
high probability of further disease activity
Significance of early disease activity
Likely impacts long-term disability
What types of cognitive/emotional changes occur early on in MS?
- cognitive changes
- depression
- fatigue
Impact of tx following first clinical event
- Delay conversion to definite MS
- Reduce brain atrophy and disability worsening
Why does tx need to be ongoing for MS?
- once tx is initiated, it needs to be ongoing for benefits to continue
- cessation negatively impacts outcomes
- relapse rates can return to baseline if tx is interrupted
What happens to FSS and EDSS scores if tx is stopped and relapse rates return to baseline?
both increase
rationale for access to full range of tx options: use of interferon beta and natalizumab
- frequently associated with development of neutralizing antibodies
- reduces clinical efficacy
rationale for access to full range of tx options: contraindications, nonresponders
need access to options
rationale for access to full range of tx options: severity of disease
- varies at onset
- some experience early aggressive disease
rationale for access to full range of tx options: African Americans
Some have more active disease
rationale for access to full range of tx options: adherence
Some people don’t adhere to tx regimen and need access to options
