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Understanding Multiple Sclerosis Medications (cont.)

Miscellaneous Therapies and Medication for MS

Fingolimod (Gilenya®): Fingolimod (Gilenya®) is a daily oral medication to treat MS that was approved by the US FDA in September 2010 as the first oral medication to treat MS. Although the exact mechanism of action of fingolimod is unclear, it appears to work by reducing the number of lymphocytes (a type of white blood cell that is important for immunity and the inflammation process) in the blood. Fingolimod is taken daily in capsule form. It is not a cure for MS, but it has been shown to decrease the number of MS flares and slow down the development of physical disability caused by MS. Like many injectable therapies for MS, the long-term safety of fingolimod is unknown. The most common side effects of fingolimod are headache, flu, diarrhea, back pain, elevations of liver enzymes in the blood, and cough. Other side effects are also possible including eye problems, so those taking this drug should have regular ophthalmologic evaluations.

Plasmapheresis (plasma exchange): This therapy is sometimes attempted for severe attacks that do not respond to corticosteroids. This therapy is expensive, not FDA approved for multiple sclerosis, and its efficacy is controversial.

IV immune globulin (IVIG): Although not FDA approved for multiple sclerosis, some studies have suggested that IVIG can reduce the rate of a second attack when IVIG was administered over 6 weeks following a first attack. Other researchers found no benefit when given to patients who had multiple sclerosis for at least 3 years. Yet others have studied IVIG when given on a regular monthly schedule and found a small but significant benefit of improving clinical disabilities and fewer relapses.

Investigational Drugs for MS

Research into additional treatment options continues to advance. Multiple approaches are being investigated based on the increasing knowledge about immune system abnormalities and CNS lesion formation in multiple sclerosis. These include approaches to counteract or reduce immune system activation, blood brain barrier disruption, neuronal loss, and myelin loss, among other investigational efforts.

Medically reviewed by Jon Glass, MD; American board of Psychiatry and Neurology

Medically Reviewed by a Doctor on 8/4/2014
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