The new drugs for multiple sclerosis (MS) are more effective than current standard therapies and allow young patients to stay fit longer, the experts remind. Therefore, their reimbursement is profitable, also for the society, they point out.
Multiple sclerosis is an incurable neurological autoimmune disease that manifests itself mainly in young people between the ages of 20 and 40. If left untreated or treated poorly, it can lead to disability faster.
It is all the more pleasing that the treatment options for MS have progressed significantly in recent years. The catalog of MS drugs is constantly expanding with preparations that, apart from being highly effective, also improve the quality of life of patients. Among them are oral and injection therapies that require less drug administration than today, says Prof. Krzysztof Selmaj, head of the Department and Clinic of Neurology at the Medical University of Lodz.
Currently, patients with MS under the so-called In the first line of treatment, they receive drugs (beta interferons or glatiramer acetate) in the form of subcutaneous or intramuscular injections, which are not easy for everyone to accept. The challenge may be not only painful injections, but also persistent side effects or the need to subordinate the daily rhythm to taking the preparation – if the patient has to use it, for example, every day – emphasizes prof. Selmaj.
In addition, standard immunomodulating therapies are effective in approximately 30% of patients. patients. For this reason, the search for new drugs that would be effective in a larger group of patients is still ongoing. Currently, in many countries around the world, a new oral drug – dimethyl fumarate is chosen instead of standard immunomoulant therapies. In Poland, it is not yet financed under the drug program.
This drug is becoming the drug of first choice in many countries, especially in patients with newly diagnosed MS. It is characterized by higher efficiency, good safety profile and greater ease of use – explains Prof. Adam Stępień, head of the Neurological Clinic of the Military Medical Institute in Warsaw. According to him, the higher effectiveness of the drug is associated with both the reduction of the number of relapses (i.e. relapses or intensification of MS symptoms) and the inhibition of the progression of disability – both in the shorter and longer periods.
This is confirmed by the data presented in April 2015 at the congress of the American Academy of Neurology in Washington. In the ENDORSE study conducted in a group of nearly 1800 patients, it was shown that within five years, more than 81% disability progression was not observed, and in approx. 60% patients did not relapse. The data from all studies on this drug also confirm its good safety profile.
Therefore, I believe that this drug should be widely available also in Poland as soon as possible, especially for young people in whom MS is aggressive, with numerous relapses in the initial period. They translate into the patient’s disability. If he has 5-7 relapses in the first years of the disease, he will become disabled faster – emphasizes prof. Stępień.
As he points out, this is about people aged 25-30, because it is mainly the population of people most often diagnosed with MS. And it makes a huge difference whether a person aged 30 will be disabled, in a wheelchair, dependent on the environment, or will be fully independent – says the neurologist.
In his opinion, the fact that the drug is oral is also an advantage. “In the case of chronic disease, punctures performed daily, every other day or once a week are very burdensome and poorly tolerated by patients” – emphasizes prof. Stępień.
Therefore, apart from oral medications, medications are being developed that can be injected less frequently, such as the newest pegylated interferon beta 1a, which can be injected once every two weeks.
Currently, work is underway in Poland to introduce new drugs for MS to drug programs. Among them is also alemtuzumab, a monoclonal antibody directed against CD-52 antigens on certain immune cells. It is highly effective in patients who are not effective in standard immunomodulating therapies.
Neurologists increasingly emphasize that MS is a very diverse disease, which varies differently in individual patients, due to the fact that its development may be dominated by various biological mechanisms. Therefore, access to a diverse range of therapies means that more patients can be helped, concludes Prof. Stępień.