Multiple sclerosis (MS) is a disease that affects approximately 45 people in Poland. people. Of these, only about 12 are treated. patients, which accounts for 26% of patients. This result is alarming compared to the average for the entire European Union, which is around 50 percent. We check what treatment options are available in Poland for a person suffering from MS.
Currently, there is no cure for MS, so multiple sclerosis is considered an incurable disease. Nevertheless, there are a number of medications that can delay the progression of the disease as well as alleviate the aftermath of relapses and other accompanying symptoms. Rehabilitation is also important, as it plays an important role in the process of maintaining fitness in MS patients.
Pharmacological treatment can be divided into four basic groups:
- Immunomodulating therapy – slows the progression of the disease, influencing inflammation in the CNS. It reduces the number of relapses, the progression of disability and the number of demyelinating changes in the brain. They are used primarily in the relapsing-remitting form of MS (RRMS), less frequently in the relapsing forms of the chronic disease. In Poland, the following are used: interferon ß 1a, interferon ß1b, glatiramer acetate, Natalizumab, Fingolimod;
- Immunosuppressive therapy – Immunosuppressants are less selective than immunomodulators. Currently, there are no conclusive studies that would indicate their effectiveness in the treatment of MS. These drugs also have more significant side effects. In Poland, mitoxantrone is used, among others, in the case of severe, rapid relapsing-remitting MS or in the secondary progressive form.
- Treatment of relapses – drugs called corticosteroids (popularly known as steroids), which are anti-inflammatory and immunosuppressive, are most commonly used to relieve a relapse, leading to relief of symptoms;
- Symptomatic treatment – the most common symptoms in multiple sclerosis that can be tested with pharmacological treatment include: spasticity, disorders of the urinary tract, fatigue, pain, tremors, sexual dysfunction, depression and cognitive disorders.
Until now, patients not only had to apply for participation in drug programs in order to receive expensive drugs for free, but also had to keep an eye on visits to various specialists in order to constantly investigate emerging ailments that could (but did not have to) be the result of MS. This involved, among other things, presenting the medical history to each of the specialists (who did not have access to the previous documentation) or a long wait for an appointment, which often ended with going to a private clinic to perform tests on time, not in a few months. On their own, they also had to take care of rehabilitation, which is a key element in the treatment of multiple sclerosis.
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Over the years, patients with MS have asked for comprehensive care. After months of preparations, on July 16, 2019, a pilot program in the field of hospital treatment was officially launched – comprehensive services provided in coordinated care for patients with multiple sclerosis (MSM). The pilot project was created, among others thanks to the efforts of the Urszula Jaworska Foundation – for years involved in pro-propositional changes in the health care system.
As we read in the ordinance, comprehensive care for patients with multiple sclerosis (MSM) is to include: diagnostic and therapeutic procedures, specialist outpatient services and, depending on medical indications, various forms of rehabilitation, and its therapeutic goal is to suppress disease activity – to inhibit its progress , reducing the occurrence of relapses and the appearance of new demyelinating changes, and reversing the existing changes in the nervous system, in particular by:
- diagnostics, including verification of the diagnosis of multiple sclerosis (MS), verification of the relapse diagnosis, control magnetic resonance imaging (MRI) of the brain or spinal cord without contrast or with contrast;
- therapy according to clinical indications: in patients with symptoms of significant spasticity – access to baclofen pump therapy, and in patients with symptoms of neurogenic bladder – access to Drug Program B.73. (treatment of neurogenic detrusor overactivity ICD-10N31);
- outpatient specialist care (access to specialist doctors);
- comprehensive therapeutic rehabilitation;
- care in the field of psychology and psychiatry;
- cooperation with a doctor and nurse of primary health care (POZ).
Thanks to the program, patients with multiple sclerosis will have access to specialists who understand the essence of MS in detail. Comprehensive rehabilitation, which many patients could not afford, or the care of a psychologist and psychiatrist, is also important, as many MS patients suffer, among others, from for depression.
In addition to using drug programs, a patient with MS can also take part in clinical trials that are conducted in specialized centers and under the strict supervision of specialists and relevant state authorities. Clinical trials are drug research programs that are conducted with patients. Their goal is to check to what extent the new form of therapy is effective and to determine whether it is safe.
Source:
– Order of the President of the National Health Fund No. 93/2019 / DSOZ, www.nfz.gov.pl
– Polish Society of Multiple Sclerosis, www.ptsr.org.pl