Modern therapies

Treating multiple sclerosis at an early stage

(Bild: stock.adobe.com/ralwel - stock.adobe.com)

 Multiple sclerosis (MS), the most common inflammatory disease of the central nervous system, cannot yet be cured, but in many cases it can be treated well. It is important to find the optimal therapy for each patient at the right time.

As the causes of MS are not yet fully understood, there is still no cure. However, thanks to medical advances, many patients can now lead an almost normal life. It usually affects young people between the ages of 20 and 40, and women are twice as likely as men.

In the majority of those affected, the disease occurs in recurring relapses (relapsing-remitting MS). It often turns into a continuous progression at a later stage (secondary progressive MS, or SPMS for short). Around 15 percent of people with MS suffer from a primary progressive form with a steady increase in symptoms.

As varied as the clinical picture is, with a whole range of neurological symptoms, as extensive is the range of therapies available. In addition to symptom-reducing measures, there are moderately effective to highly effective medications. 

When to start which therapy?
In an acute inflammatory attack, glucocorticoids (cortisone) are usually used for a short time to reduce the inflammatory processes in the central nervous system. Progression-modifying therapy is used to permanently suppress disease activity and prevent or at least slow down further progression.

A number of substances are approved for this purpose, with different mechanisms of action, specific forms of application, but also side effects. These drugs have a regulatory effect on the immune system and suppress its dysregulation. Which drugs are used here is decided individually by the doctors on the basis of various factors (age, gender, life situation, concomitant illnesses, current disease situation of the patient).

The early use of highly effective medication has significantly improved the prognosis for MS sufferers.

Univ.-Prof. Priv.-Doz. Dr. Barbara Kornek, Präsidentin der Multiple Sklerose Gesellschaft Wien

Bild: Johannes Zinner

The faster treatment is initiated, the better the ability to influence the course of MS. Waiting can lead to faster progression of nerve damage, which is sometimes not even noticeable. In the past, the main treatment strategy chosen was to initially prescribe a moderately effective drug and only then switch to highly effective therapies if the disease progressed anyway.

Early use of highly effective drugs
If a patient receives a basic therapy and responds well to the moderate medication, they may not need a highly effective drug. However, this carries the risk of wasting valuable time during which MS can continue to progress silently. For this reason, many experts are now pursuing the "hit hard and early" strategy, i.e. the early use of a highly effective therapy immediately after diagnosis.

"The early use of highly effective medication has significantly improved the prognosis for MS sufferers," reports Prof. Priv.-Doz. Dr. Barbara Kornek, President of the Multiple Sclerosis Society Vienna. When it comes to finding the right treatment strategy, it is important to find the best therapy for each individual patient at the optimal time.