Multiple sclerosis: Difference between revisions
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Interferon-β was first approved for the treatment of MS in 1993. The drug has shown to be extremely effective on RRMS and SPMS, though more so on RRMS, with a reduction in relapse rate, decrease in disability progression, and MRI evidence of disease activity. While the exact mechanism of effectiveness is not known, it is quite clear that when administered, interferon-β is extremely effective at slowing the progression of the two less severe types of MS. Two types of interferon-βs exist on the market: interferon-β 1a and interferon-β 1b. Interferon-β 1a products ''Avonex'' and ''Rebif'' are recombinant peptides that are produced in Chinese hamster ovary cells and are identical to natural human Interferon-β. ''Avonex'' is injected intramuscularly once a week, while ''Rebif'' is injected subcutaneously three times a week. Interferon-β 1b products ''Betaseron'' and ''Extavia'' are produced recombinantly in ''Escherichia coli bacteria'' and administered subcutaneous injection every other day. The sequence is only one residue off from that of human Interferon-β. Interferon-β 1b is titrated to a target dose over 6 weeks. All four of these major market drugs bind to the same human interferon receptor.<ref>'MS:Pathogenesis and Treatment'</ref> | Interferon-β was first approved for the treatment of MS in 1993. The drug has shown to be extremely effective on RRMS and SPMS, though more so on RRMS, with a reduction in relapse rate, decrease in disability progression, and MRI evidence of disease activity. While the exact mechanism of effectiveness is not known, it is quite clear that when administered, interferon-β is extremely effective at slowing the progression of the two less severe types of MS. Two types of interferon-βs exist on the market: interferon-β 1a and interferon-β 1b. Interferon-β 1a products ''Avonex'' and ''Rebif'' are recombinant peptides that are produced in Chinese hamster ovary cells and are identical to natural human Interferon-β. ''Avonex'' is injected intramuscularly once a week, while ''Rebif'' is injected subcutaneously three times a week. Interferon-β 1b products ''Betaseron'' and ''Extavia'' are produced recombinantly in ''Escherichia coli bacteria'' and administered subcutaneous injection every other day. The sequence is only one residue off from that of human Interferon-β. Interferon-β 1b is titrated to a target dose over 6 weeks. All four of these major market drugs bind to the same human interferon receptor.<ref>'MS:Pathogenesis and Treatment'</ref> | ||
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== Other Treatments== | == Other Treatments== | ||
There are many other treatments for MS ranging from small polymers to monoclonal antibodies to cytotoxic agents. While all have their benefits, they also have their side effects. While clinical trials can out short-term effects, long-term effects are a continuous threat and worry to contend with. Treatment of women, who are more effected than males, is particularly dangerous when the woman is potentially pregnant. Another great concern is the safety of treating children.<ref>'MS:Pathogenesis and Treatment'</ref> | |||
=== | ===Glutarimer Acetate=== | ||
Formerly known as copolymer 1, '''glutarimer acetate''' (GA) is a random polymer of glutamic acid, lysine, alanine, and tyrosine which are the most common amino acids in MBP. As with Interferon-β, the exact mechanism of glutarimer acetate is not yet known, although Racke et al. have shown that GA inhibits response of various antigen-specific murine T cell hybridomas in addition to blunting human MBP-specific T cell lines from lysing targets in the presence of three human leukocyte antigen-DR types associated with MS. Additionally, studies have shown that GA increases cytokine levels, anti-inflammatory action, and acts upon CD8+D T cells by correcting their regulatory deficit. The only drug on the market is called ''Copaxone'' and it is approved for use of treatment of RRMS. It has shown effects on exacerbation rate and MRI clinical assessment. ''Copaxone'' is injected subcutaneously on a daily basis.<ref>'MS:Pathogenesis and Treatment'</ref> | |||
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===Monoclonal Antibodies=== | |||
Natalizumab, Alemtuzumab, Rituximab, Daclizumab. | |||
===Cytotoxic and Other Agents=== | |||
==References== | ==References== | ||
