Multiple Sclerosis (MS) is a chronic neurological condition that affects the brain, spinal cord, and optic nerves, which together form the central nervous system. This unpredictable disease can disrupt the flow of information within the brain and between the brain and the body. While there is no cure for MS, infusion therapies represent a significant treatment approach for managing the condition.
What Infusion Therapy Means for MS
Infusion therapy for MS delivers medication directly into the bloodstream intravenously. This method allows faster absorption and more effective symptom management than oral medications. Infusions are frequently used for certain forms of MS, particularly when oral medications are not sufficient or for highly active disease.
The primary purpose of these therapies is to modify the disease course by reducing the frequency and severity of MS relapses. Infusion treatments also aim to slow disease progression, mitigating the accumulation of disability over time. By achieving these goals, infusion therapy can enhance the overall quality of life for individuals living with MS.
Specific Infusion Medications for MS
Several key medications are administered via infusion to treat multiple sclerosis, each targeting specific aspects of the disease.
Natalizumab
Natalizumab (Tysabri) prevents certain immune cells from entering the brain and spinal cord, reducing inflammation and relapses in relapsing forms of MS. This medication is typically given every four to six weeks.
Ocrelizumab
Ocrelizumab (Ocrevus) is approved for both relapsing forms of MS and primary progressive MS. It targets specific immune cells called B cells, which are believed to contribute to nerve damage in the central nervous system. Patients usually receive an initial split dose, followed by infusions every six months.
Alemtuzumab
Alemtuzumab (Lemtrada) targets and depletes immune cells that contribute to inflammation. Used for highly active relapsing MS, it is administered in two courses, with the second course given one year after the first.
Mitoxantrone
Mitoxantrone (Novantrone) is a chemotherapy drug sometimes used for aggressive forms of MS, including secondary progressive MS and worsening relapsing-remitting MS. It broadly suppresses the immune system and is generally reserved for severe cases when other treatments are not effective due to potential side effects. It is administered approximately every three months, with a lifetime maximum dose due to potential cardiac risks.
How Infusions Combat MS
Infusion therapies combat MS by modulating or suppressing the immune system, which mistakenly attacks the central nervous system. These medications reduce the inflammatory response that leads to damage of the myelin sheath, the protective covering around nerve fibers. By targeting specific immune cells or pathways, infusions prevent these cells from causing further harm to nerve tissue.
The goal is to lessen the immune system’s attack, reducing inflammation and preventing the formation of new lesions in the brain and spinal cord. While the exact mechanisms vary between medications, the overarching principle is to rebalance immune system activity to protect the nervous system.
The Infusion Treatment Experience
MS infusions are typically administered in a clinical setting, such as an infusion center, specialized clinic, or a doctor’s office. Patients can expect a comfortable environment, often equipped with amenities like reclining chairs, Wi-Fi, and sometimes snacks and beverages. Infusion session duration varies by medication, commonly ranging from one to four hours.
Before the infusion, healthcare professionals will conduct a pre-infusion assessment, which may include checking vital signs and reviewing medical history. Patients might receive premedications, such as antihistamines or corticosteroids, to reduce the likelihood of infusion reactions. During the infusion, medical staff continuously monitor the patient for safety and comfort.
Preparation for an infusion involves staying well-hydrated and getting adequate rest the night before. Patients are advised to wear comfortable clothing that allows easy access to their arms for the intravenous line. Bringing items for entertainment or comfort, such as a book or personal blanket, can enhance the experience.
Ongoing Management and Considerations
After an MS infusion, patients are typically monitored for about an hour for any immediate infusion reactions before discharge. These reactions can include symptoms like rash, hives, headache, or nausea. Healthcare providers discuss potential side effects and provide instructions for post-infusion care.
The frequency of infusions depends on the specific medication, ranging from monthly to annually. Consistent communication with healthcare providers is important to manage side effects, adjust treatment plans as needed, and address any concerns.
Patients are encouraged to report any new or worsening symptoms or unusual reactions to their medical team. Lifestyle adjustments, such as maintaining hydration and avoiding strenuous activity immediately after an infusion, can complement the therapy. Ongoing monitoring for potential complications, such as infections due to immune suppression, is also an important part of long-term management.