The realm of MS management, as we reviewed in our January/February edition, continues to see promising developments. From the approval of oral sustainedrelease dalfampridine to the recent positive FDA action on fingolimod (FTY720), the announcement that alemtuzumab now has FDA fast-track status, and the availability of new in-office OCT scanning for axonal loss suggestive of MS, the developments have been coming at a dramatic pace—and they are welcomed by patients and physicians.
Among the trends in MS therapeutic development there is a focus on offering efficacy balanced with convenience. The availability of oral therapy for a chronic disease like MS can have important implications for patient care. Given that disease-modifying therapies for MS have all been injectable, patients have had to adjust to the notion of regular needle sticks. A survey published last year found that about 20 percent of patients with MS delay initiation of treatment, most often due to anxiety about treatment. The study, reported by The National Multiple Sclerosis Society in collaboration with EMD Serono, also found that nearly one-third of people living with MS reported that their current MS treatment interferes with their quality of life and daily activities such as work/career, exercise routine and sleeping habits.
Theoretically, the availability of oral therapies can help allay anxiety and have a less significant impact on patients' quality of life. New oral therapies aren't right for every patient, however, and those individuals with MS must recognize that the currently available disease-modifying therapies offer a high degree of efficacy and reliability for a significant proportion of patients.
Neurologists know that dialogue with patients is an essential element of care in chronic neurologic diseases, such as MS, as well as Parkinsons, epilepsy, and dementia. If nothing else, ongoing coverage of new therapeutic developments may encourage patients to talk to their doctors about their treatment choices and their overall quality of life. A cure for MS or any other of the most common neurodegenerative diseases remains elusive, but very good treatment options exist and continue to emerge.