Multiple Sclerosis: Multiple Challenges, Multiple Solutions

WebMD Live Events Transcript

According to the Multiple Sclerosis Foundation, more than 350,000 persons in the United States today are living with the multiple challenges of multiple sclerosis (MS). In observance of National MS Education and Awareness Month, neurologist Howard L. Weiner, MD, joined us on March 3 to answer your questions.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Welcome to WebMD Live, Dr. Weiner. What are the biggest challenges for the MS patient today and what are some of the newest solutions that are being looked into as far as treatment, quality of life, and pain management?

The first and biggest challenge is to be followed carefully by your doctor, to undergo therapy and have the therapy monitored. Another series of challenges relate to lifestyle: depending on the type of MS, not letting the MS interfere with the patient's lifestyle, to have a positive attitude and to realize there's a lot of research and advances in MS that have happened in the last 10 years and that are ongoing.

"We really need more time to follow patients and learn about what happened to protect against any unwanted side effects."

Tell me more about the recent drug, Tysabri, pulled from the market because of one death.

Tysabri, as everyone knows, was recently pulled from the market because of two serious side effects, one of them death. The scientific community and Biogen Idec and Elan [Tysabri's makers], are now examining very carefully all patients treated with Tysabri. It is generally believed the complication was related to Tysabri, although more data is needed.

Tysabri works by stopping white blood cells called T cells from entering the brain. It is believed that it also stopped important T cells which keep a certain virus in the brain under control. Because these T cells were blocked, the virus was reactivated and led to these serious side effects.

What is needed now is longer-term follow-up on all patients who received Tysabri to see how common this is, whether there are any patterns and whether it occurred in patients receiving Tysabri alone or only in patients receiving Tysabri plus Avonex. We don't know the answer.

It was absolutely correct to stop treatment with the drug at this time because it is theoretically possible, if more people were treated and this is a common side effect, there would be many serious side effects and deaths. It is also possible that this is a very rare occurrence and after watching and monitoring people, the drug could be reintroduced. We really need more time to follow patients and learn about what happened to protect against any unwanted side effects.

How do you feel about the fast-tracking drugs like Tysabri?

I think it is important to fast track drugs. The safety profile of Tysabri was very good. Obviously one can do Monday morning quarterbacking and say this drug perhaps should not have been fast tracked, but I believe it was logical to get it on to the market.

Do you see any other drugs coming to market soon for MS?

There are many drugs being tested and I believe there are a number of drugs that could come to market in the next five years. There are also drugs approved for other indications that have shown some efficacy in MS and could be used now in MS patients. There are immunosuppressive drugs used in transplantation and drugs used for certain other immune conditions that have been shown to help MS patients, and these drugs could be used by physicians if the patients required them.

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