Prednisone and methylprednisone are both administered orally. They follow a treatment that relies on a high dose of intravenous methylprednisone for about four days during the attack of MS (IV treatment).

The purpose of corticosteroids use

The medicines of this class are very effective against acute attacks of MS and acute optic neuritis problems.

Efficiency

Corticosteroids decrease the severity and frequency of MS symptoms and drive to a more rapid recovery, but they were not proved to stop or diminish the progress of the disease.

In case of optic neuritis attack, IV methylprednisone is the first step of the treatment. Then, oral administration of prednisone follows; used alone, this medicine can increase the probability of another optic neuritis episode.

Side effects

On short term, corticoids generate a small number of side effects. some of these are:

* – Insomnia
* – Agitation and anxiety
* – Depression.

Once the treatment is interrupted, so are the side effects.

High doses or long term treatment involving corticosteroids generate much more severe side effects:

* – Face swelling and weight gain
* – Diabetes or other blood sugar problems
* – Osteoporosis
* – Hypertension
* – Cataracts
* – Stomach and intestinal bleedings
* – Decreased resistance to infections
* – Paranoia, psychosis and serious agitation
* – The death of the tissue of bones because of insufficient blood supply

These effects rightfully worry people with frequent attacks of MS, that desperately need them.

General information

Corticosteroids that are administered intravenously (the IV treatment) have less side effects and act more rapidly than the oral forms. However, the treatment with IV methylprednisone is often effectively followed by the one using oral methylprednisone. The doses are gradually reduced by the end of the treatment to encourage the organism’s own production of corticosteroids.

One disadvantage of this treatment is that it doesn’t suit every person that needs it. In some of the cases, long term use determines an efficiency loss.

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It is an injectable medicine applied beneath the skin every day. The pills containing the same substances have proved no efficiency.

The purpose of its use is to fight the relapsing – remitted form of multiple sclerosis in adults.

Efficiency

People with relapsing – remitted MS that use glatiramer acetates have experienced and are still experiencing a decrease of number of relapses and tissue damage on the brain and spinal cord. These results were monitored by MRI.

Another advantage of this medicine is the absence of the symptoms similar to those of flu present in the interferon beta treatment but it doesn’t have the last one’s power and efficiency.

This medicine didn’t show any improvement in primary – progressive MS nor was it tested for secondary – progressive form.

The side effects

The side effects are present soon after the injection. Some of these effects are:

* – Flushing
* – Anxiety
* – Tightness in the throat
* – Pain, redness and inflammation of the shot site
* – Pain in the chest, increased heart rate, shortness of breath.

Fortunately, they are not severe and don’t last for a long time. However, during treatment some episodes may take place.

Other side effects of glatiramer acetate are:

* – Nausea
* – Weakness
* – Pain of the articulations
* – Muscular tension or spasm
* – Skin rash
* – Sexual disabilities.

General information

In case of intolerance to the side effects of interferon beta or if that treatment brought no improvement to your condition, glatiramer acetate represents the best solution.

Most of the people have a good tolerance to this medicine also because the so annoying flu like symptoms generated by interferon beta’s side effects are absent in this case. But the positive effect of this treatment appears very late, about six months instead of one as in the case of interferon beta.

The National Multiple Sclerosis Society forbids the use of glatiramer acetate unless a clear diagnosis of relapsing – remitted MS is present. The diagnosis should be immediately followed by the start of a treatment using either glatiramer acetate or one of the interferon’s class.

Disadvantages of glatiramer acetate may include besides its side effects:

* – The treatment may or may not work depending on the person’s particular situations.
* – There is no information about the long term risks. For people with easy forms, the possible risks may overcome the positive effects.
* – It has very high costs – 10 000 $ per year.

The treatment mustn’t be interrupted without the approval of your therapist.

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Interferon-beta seems to annihilate the effect of a very dangerous factor that activates MS symptoms: gamma interferon.

Avonex is administered by injection into the muscle of the thigh, upper arm, or hip weekly. is also an injection that is inserted beneath the skin about 3 times in a week; Betaseron is administered the same way as Rebif every other day.

The treatment including interferon beta medicines deals with relapsing-remitting forms of MS .Although it is tested on adults and, thus, more recommended to them, interferon-beta is also used in children.

Betaseron received the approval of U.S. Food and Drug Administration (FDA) in the treatment of people with secondary progressive MS

The Effectiveness

Based on studies, it was proved that:

Interferon beta treatment produced a significant decrease in number and severity of MS relapses. People who were administered Betaseron injections, once in two days and those that used Rebif for three times during a week were 1/3 less affected by relapses.

* – Less surfaces of the brain are affected by MS in the people that are on interferon. There MRI scans have shown this improvement of the condition and also that interferon beta doesn’t allow the formation of lesions.

* – In case of relapsing remitted form, Avonex. Rebif or Betaseron prove their efficiency in minimizing disability chances and in delaying it in other cases.

* – Betaseron seems to delay the progress of MS in the secondary progressive form and, thus, disability.

* – Also for relapsing – remitted form of MS, Avonex and Betaseron delay the cognitive impairment.

Both Avonex and Betaseron have been approved by FDA, the first one to deal with early lesions or changes of MS detected by MRI and the other – for the other for the treatment for the secondary – progressive form and also that of relapsing – remitted form.

All three interferon beta compounds are effective, but better results seem to be obtained from more aggressive treatment (Betaseron, Rebif) compared to the low doses of Avonex’s effects. Rebif is more effective by 12 percents in the prevention of relapses than Avonex, says a study which also shows the superiority of Rebif to Avonex regarding the lesions of the brain: they were much fewer in case of Rebif use.

Side effects:

* – Similarly symptoms to those of flu: tiredness, high body temperature, muscle aches that appear about a day after the administration of injections.

* – Headaches that appear from the first six months of treatments. Depending on their severity, the doctor will decide whether to change the medicine to glatiramer acetate.

* – Depression may appear, generated by interferon beta medicines. The labels of these medications contain a mention of this possibility. Avonex is the one that generated most of this kind of side effects. It is not recommended for people with serious psychiatric problems, especially depression. In case of mood fluctuation, depression or suicidal ideas, the doctor should be immediately informed.

* – The site where the injection was administered may inflame, turn red and present an increased sensitivity. Usually this is generated by Rebif and Betaseron. A pain reliever that precedes and follows the injection may be the best solution.

* – Common symptoms to these of MS: anxiety, confusion, loss of appetite and insomnia. In case they last for more than 2 days, the doctor should know about it.

Blood tests are necessary for people on interferon beta treatment; so that their leucocytes and the liver’s function may be monitored because this kind of medications may seriously damage them.

The interferon beta medication mustn’t be started until the MS diagnosis is a fact. Once it is diagnosed, this kind of therapy should be administered as soon as possible to prevent or stop the degradation of the nervous system functions due to the unpredictable nature of the disease.

The FDA and the producer of Avonex warn the people to avoid using this medicine in case of depression or another psychiatric condition because it makes their symptoms worse. Your doctor will tell you whether Avonex suits your case.

The annoying part of interferon beta treatments is represented by their side effects, that most frequently include flu like symptoms after the injection is administered. Ibuprofen, Napraxen or Acetaminophen improve these symptoms and increase your tolerance for higher doses of interferon beta compounds that really help MS.

Except for their side effects interferon beta treatment presents other disadvantages too:

- A person cannot be sure that the treatment will be effective in his/ her particular case; sometimes it may just not work.

- The risks of long term medications haven’t been discovered yet.

- In time, interferon may loose its efficiency because the body learns how to annihilate its effects by means of antibodies.

- It is a very expensive treatment, over ten thousands $ each year

This kind of treatment isn’t appropriate for pregnant women because it may produce a miscarriage. The women that follow this treatment must use birth control methods. In case pregnancy occurs, see your doctor as soon as possible and demand his advice.

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