NS: Multiple Sclerosis Flashcards
What is the most common pattern of MS?
Relapsing-remitting.
Characterised by periods of exacerbation of symptoms (relapses) followed by unpredicatable periods of stability (remission).
Most patients develop secondary progressive MS disease how many years after initial onset?
6-10 years after onset.
Primary-progressive multiple scletosis follows a gradual course, with the development of symptoms that worsen over time, without relapses and remissions. What is the course of progressive-relapsing multiple sclerosis?
Progressive-relapsing multiple sclerosis follows a course of steadily worsening neurological function from the onset, in addition to acute relapses.
What is Active MS disease defined as?
At least two clinically significant relapses occuring within the last two years.
Highly Active MS disease is characterised by?
Unchanged/increased relapse rate or by ongoing severe relapses compared to the previous year, despite treatment with interferon beta.
What are the aims of MS treatment?
There is currently no cure for MS. The overall aims of treatment are to modify the course of the disease and manage symptoms, in order to improve quality of life.
Treatment is aimed at reducing the frequency and duration of relapses and at preventing or slowing disability.
Should patients be offered vitamin D soley for the purpose of treating multiple sceloris?
Low levels of vitamin D are believed to be a risk factor for developing MS. Patients with diagnosed MS are usually given regular vitamin D after assessment of their serum levels of vitamin D, but there is insufficient evidence to support its use as a treatment for MS.
Disease-modifying drugs are the recommended treatment for patients presenting with active relapsing-remitting multple sclerosis. What are the two options which may be the preferred choice for some patients, due to their established safety profile?
Interferon beta.
Glatiramer acetate.
What advantages does Peginterferon beta-1a have over non-pegylated interferon beta therapies?
Less frequent administration
What are the two treatment options for patients with active MS disease?
Teriflunomide.
Dimethyl fumarate.
Why may Teriflunomide and dimethyl fumarate be preferred as treatment options for patients with active disease?
They have an oral route of administration.
Can teriflunomide or dimethyl fumarate be used to treat highly active or rapidly-evolving severe relapsing-remitting multiple sclerosis?
There is insufficient evidence for the use of either teriflnomide or dimethyl fumarate to treat highly active or rapidly-evolving severe relapsing-remitting multiple sclerosis.
More active MS disease may be treated with natalizumab or alemtuzumab. Why may natalizumab be preferred due to what?
Due to the complex safety profile associated with alemtuzumab
Natalizumab is only recommended for the treatment of what?
Rapidly-evolving severe relapsing-remitting multiple sclerosis.
Fingolimod is taken by the oral route for MS, it is recommended for the treatment of what?
Patients with highly active disease.
