ImmunoSupressive vs Immunomodulator Therapies for Multiple Sclerosis

Stuart SchlossmanMS Drug Therapies, Multiple Sclerosis

What are immunosuppressive drugs?

Research indicates that MS is an autoimmune disease. As immunosuppressants have been proven to be beneficial in other autoimmune diseases such as rheumatoid arthritis and psoriasis, drugs that have an immunosuppressant function have shown to be potentially beneficial in controlling disease progression in patients with MS.

Immunosuppressive drugs work by suppressing the body’s immune reaction, and they prevent the body’s ‘good’ white cells (leukocytes) from attacking each other. Normally, leukocytes help regulate the immune system. Immunosuppressive drugs offer another way of treating MS but they are normally used if the disease is progressing in spite of immunomodulatory treatment.

There are a variety of immunosuppressive drugs that have been used in cancer treatment and that have proved effective in treating advanced forms of MS. Specific immunosuppressive drugs used in MS therapy include azathioprine, mitoxantrone and occasionally cyclophosphamide or methotrexate.

However, only Tysabri® (Natalizumab) (in the USA) and Novantrone® (Mitoxantrone) (in the USA, France and Switzerland) are currently licensed specifically for use in the treatment of MS.

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What are immunomodulatory drugs?

Immunomodulatory drugs are Disease Modifying Drugs(DMDs), which alter the course of the disease.

Treatments for MS have been considerably advanced by the availability of Disease Modifying Drugs. Positive outcomes in people with relapsing forms of the disease have been demonstrated, including:

  • reduction in the frequency and severity of relapses; and
  • reduction of brain lesion development, as evidenced by Magnetic Resonance Imaging, (MRI), and (for some DMDs) the possibility of future disability.

As the name suggests, immunomodulatory drugs ‘modulate’, i.e. change, the disordered immune processes of MS, and have a corrective effect on the immune system. Interferons belong to this group of drugs.

Interferons are small soluble proteins or glycoproteins that, as ‘messenger substances’, modulate immune responses.

Read more about Interferons and the role they play in treating MS.

Recent results from clinical studies indicate that therapy should begin as soon as possible after diagnosis.

Dosage and route of administration of current available immunomodulatory drugs

Proprietary name

Rebif®

Avonex®

Betaferon®

Copaxone®

International
non-proprietary name

Interferon beta-1a

Interferon beta-1a

Interferon beta-1b

Glatiramer Acetate

Delivery systems

Ready to use Pre-filled syringe

Reconstitution needed / pre-filled syringe

Reconstitution needed

Ready to use pre-filled syringe

Available dosage

22 mcg three times a week or 44 mcg three times a week

30 mcg once a week

0,25 mg every other day

20 mg daily

Route of administration

Subcutaneous injection

Intramuscular injection

Subcutaneous injection

Subcutaneous injection

Other characteristics, such as indications, format, etc. may vary from one country to another. Always consult the product leaflet.

SOURCE for the above data comes from the MS-NetworkHowever, their information has not been updated in a couple of years.

Such the case that Cytoxan and Imuran are also being used for MS and are immunosupressants

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