What are MS Disease Modifying Therapies?
Dr. Bourdette explains that DMTs are treatments which alter the course of MS and control the disease. They decrease the frequency and severity of attacks of MS. This decreases the probability that someone becomes more disabled from the disease. These DMTs are grouped into "first" and "second" generation drugs.
The first generation drugs were released in the 1990s. There are two classes of these first generation drugs: beta interferons and glatiramer acetate. A beta interferon is a protein that cells in our body make. Recombinant technologies were used to turn this into a drug that can be given in high doses. It modulates the immune system and helps to control the disease in MS. Glatiramer acetate is a different class of drug. It’s not an interferon, so it works through a different mechanism. It also controls the immune system in MS.
The first of the second generation drugs was a chemotherapy drug, Mitoxantrone or Novantrone which was registered for the treatment of aggressive forms of MS. It’s rarely used now for MS because of cardio toxicity and risk of inducing leukemia. The other two second-generation drugs are used by a large number of patients. Natalizumab or Tysabri is a monoclonal antibody. These are recombinant antibodies that target specific proteins. In this case, it targets a protein on white blood cells and it blocks the white blood cells from getting into the brain and the spinal cord. The other recent second-generation drug is fingolimod. It goes by the trade name of Gilenya and it’s the first oral therapy for the treatment of MS. (4 minutes)
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