MSSANT Network Autumn 15 WEB

Multiple sclerosis
treatment update
Sue Shapland
Two more disease modifying therapies for relapsing
multiple sclerosis will soon be available in Australia with
PBS approval. New therapies are always welcome as they
increase the range of options available.
The first treatment, the interferons (Avonex®, Betaferon®
and Rebif®), only became available from the late 1990s in
Australia. They were then joined by Copaxone®. Prior to
these, no treatments were available. These self-injectable
therapies are all still in use.
Over the past six years or so, a range of other effective
products, both oral and intravenous, have joined the armoury.
Tysabri® was the first in a new class of drug, the
“monoclonal antibody” and given by monthly infusions. Then
Gilenya®, the first oral treatment became available. This has
now been joined by Tecfidera® and Aubagio®.
Over the years, ongoing trials, when compared with the
natural history of multiple sclerosis before treatments, have
shown that the greatest benefit is achieved by commencing
treatment early. The inflammatory process and relapses in
the early stages of MS result in damage that in the long term
correlates with disability levels.
Finding the right therapy, both tolerable and effective at
reducing relapses and disease activity, is a process based
on informed decision-making with your neurologist. Some
people may have to switch therapies as things change.
The latest two therapies soon to become available are:
• Lemtrada ® (alemtuzumab): It is a monoclonal antibody for
treating relapsing forms of MS in adults with active disease.
It works by depleting the B and T cells in the circulation.
This infusion is given daily for five days and then 12 months
later for three days. Trials have shown that many patients
only required two rounds of treatment.
As with all treatments there may be side effects. These can
range from infusion reactions to more serious autoimmune
reactions including over or under reactive thyroid disease
and a rare blood disorder.
People using this therapy require monthly monitoring via
blood tests for up to four years after the last infusion. Whilst
this therapy won’t be for everyone, it is an effective therapy
for consideration.
• Plegridy ® (peginterferon beta-1a): It is a self-injectable
therapy for relapsing multiple sclerosis. This interferon
beta-1a is pegylated which extends its half-life allowing
less frequent dosing, i.e. every two weeks. It is the first
pegylated interferon approved and combines efficacy with
a favourable safety profile to the existing interferons.
Fortunately, in Australia we have access to all of the
approved multiple sclerosis treatments. This isn’t the case
in many countries, reducing options for people with multiple
sclerosis and their doctors.
There are still a number of therapies in clinical trials and
more exciting is the prospect of some treatments in the
future for progressive multiple sclerosis.
If you would like any more information on multiple
sclerosis therapies, please contact MS Assist on
1800 812 311 or email us at info@ms.asn.au
Planning for discharge from the hospital
Sometimes, for one reason or another, people with MS
must spend some time in hospital. It is important to
ensure that the person and their home are set up ready
for the return. Hospital discharge liaisons are employed
by hospitals and can help plan a safe return home.
If a person requires in-home support after discharge, it is
important for the hospital discharge liaison to be involved
to help source that support prior to your discharge. Short
and medium term packages of care can be arranged
following a hospital admission, and Disability Services
can also become involved if ongoing support is required.
This may be in the form of a support worker who assists
with tasks like showering and dressing.
Please note that this type of support from Disability
Services can be requested without a hospital admission.
Please contact Disability Services on 1300 786 117 for
further details.
Home modifications, new or additional equipment may also
be needed or require adjustment, repairs or maintenance.
The hospital-based Occupational Therapist can begin the
paperwork required, helping to get the work or changes
done in a timely manner. Repairs and maintenance to
equipment that belongs to Domiciliary Equipment
Service (DES) can be arranged by calling 1300 130 302.
Suppliers can also be approached for repairs and
maintenance to equipment that belongs to others.
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Autumn 2015 The MS Society of South Australia & Northern Territory