Infusion treatments, also known as drips, deliver medication with a needle or catheter, usually through a vein.
A range of therapies is available to treat MS, and infusion can be used to deliver a number of them. One category infusion treatments for MS can involve infusion is disease-modifying therapies, which help slow MS activity and progression. Another category is therapies for relapses, which help control flare-ups. They can reduce the severity and length of a relapse, and help patients manage its symptoms.
Disease-modifying therapies
IV infusion is used to deliver such disease-modifying therapies as mitoxantrone (brand name Novantrone), natalizumab (Tysabri), and alemtuzumab (Lemtrada).
Novantrone was the first drug for relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS). It has also been used for many years to treat cancer.
Novantrone is falling out of favor with doctors because regulators have approved new disease-modifying therapies that do not have Novantrone’s severe side effects. It can trigger both heart disease and leukemia.
When a doctor prescribes Novantrone for an MS patient, it is given by IV infusion every three months.
Although doctors have switched many of their patients from Novantrone to other therapies, people with MS who have been treated with it need to have an annual heart evaluation.
Tysabri is administered by intravenous infusion every four weeks. People with MS who receive it are at higher risk of developing progressive multifocal leukoencephalopathy, or PML, a viral infection of the brain that usually leads to severe disability or death. Doctors use the TOUCH prescribing program to monitor patients for PML.
Lemtrada is given for five days by IV infusion, then followed a year later by a three-day course. It is a second-line therapy for MS, meaning it is prescribed only when other FDA-approved treatments fail to help a patient, or the patient is unable to tolerate them. Lemtrada is available only through a restricted distribution program known as Lemtrada REMS — Risk Evaluation and Mitigation Strategy. Distribution is limited to manage known or potential serious risks associated with Lemtrada.
Therapies for relapses
Most people with MS experience relapses, exacerbations, attacks or flare-ups of their diseases. A relapse involves a worsening or recurrence of existing symptoms and may involve the appearance of new ones. Relapses can last from a few days to a few months, followed by a complete or partial recovery, called a remission. To be considered a relapse, as opposed to an exacerbation, attack, or flare-up, an MS aggravation must last from 24 to 48 hours or longer.
When relapses are so severe that treatment is required, a patient receives a corticosteroid such as methylprednisolone and dexamethasone by intravenous infusion between three and five days. Corticosteroids work by reducing inflammation of the central nervous system. They lessen the severity and duration of a relapse, but do not appear to affect the long-term progression of MS.
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