Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) and is classified as an autoimmune disease. In autoimmune diseases, the immune system does not exclusively target pathogens such as viruses and bacteria. Instead, it attacks the body‘s own structures. In the case of MS, it attacks the sleeves of the nerve fibres in the brain and spinal cord, called myelin sheaths.

MS is the most common cause of non-traumatic neurological disability in young adults. Acute and chronic disease activity is common in the absence of clinical symptoms. Once a threshold of irreversible disability has been reached, it may be too late for patients to benefit from treatment.

MS can cause many symptoms, including blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more. These problems may come and go or persist and worsen over time. Most people are diagnosed between the ages of 20 and 50, although individuals as young as 2 and as old as 75 have developed it.

MS comes in several forms, including clinically isolated syndrome, relapsing-remitting MS, secondary progressive MS and primary progressive MS. The course of MS is difficult to predict. Some people may feel and seem healthy for many years following diagnosis, while others may be severely debilitated very quickly. Most people fit somewhere between these two extremes. Every individual will experience a different combination of MS symptoms, and it is hard to predict how MS will affect a person over their lifetime.

Clinically isolated syndrome: Clinically isolated syndrome (CIS) is the first episode of neurological symptoms experienced by a person, lasting at least 24 hours. The person may experience a single sign or symptom, or more than one at the same time. It is caused by inflammation and demyelination in the central nervous system. CIS is an early sign of MS, but not everyone who experiences CIS goes on to develop MS. If someone with CIS also has lesions (as seen on a brain MRI scan) that are similar to those seen in MS, then they are at higher risk. 

 Relapsing-remitting MS: In relapsing-remitting MS (RRMS, sometimes referred to as relapsing MS), people experience attacks or exacerbations of symptoms (‘relapses’), which then fade or disappear (‘remission’). The symptoms may be new, or existing symptoms may become more severe. Relapses can last for varying periods – from a few days up to months – and then the disease may then be inactive for months or years. About 85 per cent of people with MS are initially diagnosed with RRMS.

Secondary progressive MS: Secondary progressive MS (SPMS) is a secondary phase of relapsing MS that may develop years or even decades following diagnosis with relapsing-remitting MS. Most people who have RRMS will transition to SPMS. In SPMS there is progressive worsening of symptoms over time with no definite periods of remission.

Primary progressive MS: About 10 to 15 per cent of people with MS are diagnosed with primary progressive MS (PPMS). People with PPMS have steadily worsening symptoms and disability from the start, rather than sudden attacks or relapses followed by recovery.[2]

There is currently no cure for MS and the available therapies only slow disease progression. Treating earlier may reverse some aspects of early dysfunction.

Ocrevus is a medicine that represents a different scientific approach to treating multiple sclerosis. It targets a type of immune cell called the CD20-positive B cell that plays a key role in the disease.

OCREVUS has twice-yearly (six-monthly) dosing and is the first and only therapy approved for relapsing multiple sclerosis (RMS; including RRMS and active, or relapsing, secondary progressive MS [SPMS], in addition to clinically isolated syndrome [CIS] in the U.S.) and primary progressive MS (PPMS). OCREVUS is approved in over 98 countries across North America, South America, the Middle East, Europe, as well as in Australia.[3]

Ocrevus was designated as a Breakthrough Therapy by the U.S. Food and Drug Administration (FDA), and approved by the FDA in March 2017 and by the European Commission in January 2018. 

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References:

  1. https://www.msif.org/about-ms/types-of-ms/

  2. https://www.msif.org/about-ms/types-of-ms/

  3. https://www.roche.com/solutions/pharma/productid-e3f6834f-e19b-4405-9098-05a3752adeb6

     

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