In a special feature published in the journal American Health & Drug Benefits, authors Stanton R. Mehr, President of SM Health Communications, and Marj P. Zimmerman, President of RxDirections, discuss the many unmet medical needs multiple sclerosis (MS) patients still face in dealing with the disease.
Over the past few decades, research focusing mainly on the prevention and reduction of relapses in the relapsing-remitting form of MS (RRMS) have led to some therapeutic advances. But while preventing disease relapse is indeed an important treatment goal, high levels of disability is still a major obstacle in the daily lives of MS patients.
The feature, entitled “Reviewing the Unmet Needs of Patients with Multiple Sclerosis,“ plunges head-first into the rather extensive body of research investigating what MS patients still lack in terms of treatments that can make a different in their quality of life.
Delaying progression and developing better treatments for progressive MS
Progressive MS treatment and delay of disease progression have not received the same research focus as RRMS. Further delaying progression and developing better treatments for progressive MS is, therefore, one of the main points listed in this overview. A new agent, ocrelizumab — which is due to be reviewed by the FDA in 2016 — was found to decrease disability in progressive MS patients in a large clinical trial. Patients and clinicians alike hope that this drug might prove to be an advance in the treatment of progressive MS.
Researchers argue that if it were possible to protect neurons from the demyelination occurring in MS, it would translate into severely slowed disease progression and reduced disability. Research to this point has focused predominantly on potential mechanisms of neuroprotection. While current immunomodulating drugs might provide a certain level of protection against demyelination, the authors concluded that the link between these drugs and potential neuroprotection has not been sufficiently studied.
Delaying or avoiding disability
Studies into neuroprotection would also offer insights into how to delay or avoid disability — a major concern for all MS patients. Patients typically receive an MS diagnosis during the most productive years of their life and live with the disease for another 30-40 years.
Several studies show that psychological disability is not nearly addressed by clinicians as often as the patients would wish, and a large proportion of patients cite psychological factors as their greatest unmet need. Such factors undoubtedly also affect caregivers of MS patients, who are likely to receive equally little psychological support.
Physical disability has been shown to reduce employment by up to 80 percent as early as five years after diagnosis, and current medications contribute little in terms of improving physical disability. In addition to reduced mobility, many patients suffer from dysphagia (difficulty in swallowing), speech problems, and decreased vision.
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