There is a new
learning curve for
everyone in the MS
world.
raised in professional meetings, at the Society and
elsewhere, and there will be more seminars and
blue-ribbon panels.
All three doctors know that what people say about
their own health is of primary importance. “If
someone has a feeling that they are just not doing
as well as they should, they need to say so and tell
their;doctor,”;Dr.;Rolak;advised.;“They;need;to
ask if their expectations are realistic. How that’s
dealt with may depend on their doctor’s point of
view. There are a lot of different opinions.”
Dr.;Rolak;sees;the;new;era;as;similar;to;what
women with breast cancer or men with prostate cancer have faced for years. There is no one
standard treatment. The choices have to be made
patient by patient. The individual and the doctor
have to go over all the factors. “And now, in MS,
we have a similar situation,” he said.
Dr. Cohen sees a learning curve for everyone in
the MS world. He hopes people will take on the
challenge;to:
n
;Educate;themselves;using;sources;that;are;reli-able, scientifically valid and not biased by commercial interests.
n
;Recognize;that;treatment;decisions;are;indi-vidual.;Patient;and;doctor;need;to;go;over;the
pertinent issues, with a hard look at how that
individual feels about taking risks or going into
the unknown.
n Be prepared emotionally for the likelihood of
new side effects from the new drugs. “Things may
emerge in a wider population that just weren’t seen
in the clinical trials,” he said.
n Take special note of treatment choices if planning a pregnancy.
n;Learn;more;about;MRIs.;There;are;limits;to
what;conventional;MRIs;can;tell;and;no;consensus
on how often to have one. There are also concerns
about;quality.;An;MRI;needs;to;be;designed;to
reveal MS lesions and done in exactly the same
way each time so the results can be compared. n
martha King is the editor of Momentum.
AlsO IN thE RuNNINg
Laquinimod—a daily pill that appears to be
well tolerated and has shown benefits in arthritis, Crohn’s disease, type 2 diabetes and lupus.
It may affect a pivotal pathway of inflammation
and increase the proteins that protect nerve
cells from damage. this drug has been on the
FDA “fast track” since early 2009. Phase III studies may conclude in 2011.
Estriol—a daily pill for women only based
on pregnancy hormones that moderate
immune responses. this treatment emerged out
of society-sponsored studies on ms gender differences. Following encouraging Phase I results,
a large multicenter Phase II trial of Copaxone
plus estriol is recruiting now.
