This study highlights the importance of investigating the subtypes of Multiple Sclerosis with respect to definitions, diagnosis and treatment.
Dr. Ángel Chinea, neurologist, medical director of the Multiple Sclerosis Foundation. Photo: Journal of Medicine and Public Health, Fabiola Plaza.
This time it is a case where a 41-year-old woman, diagnosed with Multiple Sclerosis in 2001 (at age 21) and currently treated with alemtuzumab, who presented at the San Juan Multiple Sclerosis Center in February 2021 for a outbreak follow-up evaluation and active referrals.
On examination it was determined that the patient presented weakness bilateral lower extremities with the help of the wheelchair, neurogenic bladder, constipation, gait impairment, loss of coordination and deterioration mild cognitive.
“At the present visit, the patient was alert and oriented to space, time, and person. Medical history included a diagnosis of relapsing-remitting Multiple Sclerosis and a cesarean section. In addition, the patient experienced aggressive infection for VZV at age 12, which led to his hospitalization. The family history included Multiple Sclerosis in a cousin, a third-degree relative, on the mother’s side,” the authors of the case indicate.
They noted that the disease-modifying therapies for this patient changed several times over the years. In 2001, interferon beta 1-b was started for seven years, until 2008, when it was changed to natalizumab. He continued on natalizumab for three years, switching to glatiramer acetate in 2011 and then dimethyl fumarate in 2013.
Alemtuzumab treatment has significantly improved this patient’s cognitive abilities, motor control, and overall quality of life. Photo: Pharmaceutical.
“At that time, the patient suffered more than three relapses in less than 2 years, which that motivated a last change. The first dose of alemtuzumab it was administered in October 2016, the second dose in October/2017 and the third dose in May/2019″, details the case.
They added that alemtuzumab treatment has significantly improved cognitive abilities, motor control and overall quality of life of this patient.
Specialists explain that patients with highly active relapsing-remitting Multiple Sclerosis have limited treatment options and it is necessary to study the efficacy for recovery from deterioration in these patients.
“The discussion of this case allows us to know the beneficial results of alemtuzumab in patients with highly active relapsing-remitting multiple sclerosis. Supports previous findings of disease stabilization after alemtuzumab treatment of highly active Multiple Sclerosis. It also serves as evidence of clinical improvement and slowing of progression after following the proposed treatment for highly active or aggressive Multiple Sclerosis,” they report.
In addition, they concluded that this case serves as educational information on the therapeutic benefits of alemtuzumab in patients with relapsing-remitting Multiple Sclerosis.
“In particular, this drug appears to be beneficial for those patients with highly active MS who have not been able to improve or control their disease with DMT. Reporting these findings allows for the review of alemtuzumab as an effective treatment for patients with highly active MS.” or aggressive. Overall, this study highlights the importance of investigating MS subtypes with respect to definitions, diagnosis, and treatment,” they concluded.
Multiple sclerosis (MS) is a debilitating autoimmune disease that currently affects around 2.8 million people worldwide. It is estimated that 2,387 of them live on the island of Puerto Rico.
Access the case here.