2014 Multiple Sclerosis Research in Review

posted by Diane Holmes on Sunday, March 1, 2015

The year 2014 was a busy one for research and developments in the understanding and treatments of Multiple Sclerosis (MS).

MS continues to be the most common, and most costly, chronic disease affecting the central nervous system. The costs include more than medical care and medications. These additional costs include lost income due to disability-related unemployment, reduced quality of life, and MS-related complications.

While researchers hone in on the cause of MS, many questions remain. A recent presentation by Dr. David Hafler of Yale University School of Medicine confirmed the long-held belief that MS is an "immune-mediated disease." This includes both genetics and the environment. But, he states, "it is not bad genes or a bad environment; it is the bad interaction between genes and the environment." Environmental triggers for MS include cigarette smoking, low vitamin D levels, obesity, Epstein-Barr virus, and high salt intake.

Based on 21 years of experience with disease-modifying medications, studies find early disease-modifying treatment of MS is key to preventing disease progression and disability. In 1993 when Betaseron, the first disease-modifying drug became available, supplies were limited, and available only by a lottery system.

Now there are 11 disease-modifying drugs with more being researched. But these medications are only effective if taken regularly. Dr. Bruce Sherman, consulting corporate medical director of the Employer’s Health Coalition at Walmart Stores, Inc., points out failure to take medications has multiple causes including depression, fatigue, cognitive status, patient attitude and belief, and lack of clear instructions and attention to side effects by physicians. He states, "maybe there is a problem with the delivery system [and] we cannot just blame the patients."

Quality of life can be affected by MS and conditions that often accompany the disease, referred to as "co-morbid conditions." Examples include pain, cognitive dysfunction, depression and suicide risk, vision and hearing problems, seizures, bladder and bowel problems, and sleep disorders, which affect as much as 70% of people with MS. Depression is a significant concern. It affects people with MS at a higher rate than the general population and can be a side effect of disease-modifying drugs, as well.

At this very time more, but also increasingly expensive, treatments are available for MS and related conditions. Healthcare reform is driving the focus on patient centered care, and quality improvement requiring a multi-disciplinary approach to MS treatment. Thanks to funding from the Exceptional Persons Foundation’s "MS Services Endowment," services are available locally to support people affected by MS as they navigate the complexities of life. For more information contact Exceptional Persons, Inc. at 319-232-6671.