Available Pharmacological Options and Symptomatic Treatments of Multiple Sclerosis

Abstract

Multiple sclerosis is an autoimmune disease that targets the central nervous system and exposes the patients to a higher risk of various disabilities that impair their normal daily life activities. Different approaches take a part in the management of multiple sclerosis, in which pharmacological drug therapy is the corner stone and the central player in the treatment of multiple sclerosis. The pharmacological therapy can be categorized into; disease modifying therapies, symptomatic treatments, and relapse management. The discussed disease modifying therapies include; alemtuzumab, dimethyl fumarate, fingolimod, glatiramer acetate, natalizumab, teriflunomide and beta Interferon-1B, that have been found to share a characteristic feature of altering the immune system baseline functions in order to limit multiple sclerosis complications and deaccelerate its progression. The frequently occurring symptoms of multiple sclerosis are; depression, fatigue, general pain, spasticity, muscle spasm and other symptoms, that need to be carefully managed. Patients with multiple sclerosis face "on and off" episodes of aggravated symptoms known as a relapse that may last for days, weeks or even months. The National Institute for Health and Care Excellence guidelines have recommended the use of high corticosteroid doses as the gold-standard practice in managing a relapse episode. This review article will provide an overview of the different pharmacological therapies and their major role in the management of multiple sclerosis; via exploring the most recent published scientific evidence. In the end, a general discussion is added, focusing on the role of pharmacists and other medical experts in the clinical management of multiple sclerosis and patient support.