New Alternatives In Multiple Sclerosis Treatment Mean More Freedom For Patients
News Two years ago, Jessica Darrah from Saint John, New Brunswick, received life-changing news. The 30-year-old woman was diagnosed with multiple sclerosis (MS), joining more than 100,000 other Canadians currently living with the disease.
The first clue suggesting that there was a problem came when she experienced sight loss in one eye. She learned that this was linked to relapsing-remitting MS (RRMS), the most common form of multiple sclerosis, affecting more than 85 percent of patients. The diagnosis came after visiting an optometrist, ophthalmologist, family physician and neurologist, as well as several tests ranging from a lumbar puncture to multiple MRIs. Unfortunately, with no single method available to test for the disease, MS is a difficult condition to pinpoint.
In some ways, finally receiving a diagnosis was a relief. But with the diagnosis came a full set of new worries. Darrah knew that one of the treatment options for MS was medication administered through injection. “That was my biggest fear,” she recalls. “I didn’t want the hassle of needles. I didn’t want that daily reminder that I was sick.”
New treatments mean better quality of life
Fortunately, her physician prescribed a once-a-day pill that was approved by Health Canada in November 2013 and studied extensively and long-term across Canada. “It was such a relief,” she says. “I like to live life large. With my diagnosis, I thought that would be over.” In her future, she saw an abrupt end to her worldwide travels working as a guitarist to entertain cruise ship passengers. That hasn’t happened. She’s still globetrotting and heading to Mexico for a surfing vacation. “Things could have been a lot worse. I can live like a healthy person, and I’m so grateful for that.”
“I didn’t want the hassle of needles. I didn’t want that daily reminder that I was sick.”
As a therapeutics nurse at the MS clinic in the Ottawa Hospital, Krista O’Brien has seen the gratitude first-hand when patients learn there is an alternative to injections. “Some patients have a phobia of injections and needles, which can cause anxiety and stress around the injections themselves,” she says. “Having a once-daily oral pill option that has been long studied in Canada frees them while still being able to control their MS.”
She points out that oral medications are easier to travel with — definitely a consideration for someone like Darrah — and there are no special instructions or training required to take them. “Patients are generally thrilled to have a once-daily oral pill option,” O’Brien says. “Whether they have been already doing injections for years or are new to therapy, it is a relief for many. There is less anxiety and improved quality of life.”
Patient adherence to treatment schedule is critical
Dr. Mark Freedman, a professor of medicine at the University of Ottawa and a senior scientist with the Ottawa Hospital Research Institute, agrees. He has been researching multiple sclerosis for more than 35 years and has helped Canada become a world leader in the study and treatment of the disease.
“Until recently, the only first-line drugs that were available to our patients were injectables,” he explains. “Whether they were once-a-week or taken daily, patients experienced difficulty adhering to the treatment schedule. This makes it problematic, because we are trying to give people medication that doesn’t make them feel particularly good due to the side effects. The most recently available once-daily oral first-line treatment that we’re now prescribing is the only medication to show consistent disability results across all trials.”
Control and adherence to treatment
For a disease like MS that has no cure, control and adherence to treatment are extremely important. With a once-daily oral pill, that’s doable. “Patients don’t even notice that they are taking the medication,” says Dr. Freedman. “It is so much easier for them to adhere to the regime, and have their disease under control.”
Freedom for patients
Thankfully, for patients like Jessica Darrah, the availability of a once-daily oral pill that has been studied in clinical trials in Canada since 2000 has meant freedom and the ability to live without restriction, whether that means roaming the world or playing her guitar well for all to hear.