Multiple Sclerosis

MEDICATION COMPLIANCE WITH MULTIPLE SCLEROSIS
Multiple Sclerosis is an autoimmune disorder with no known cause or cure. Due to this fact, it is beneficial for patients begin disease modifying therapy once a definitive diagnosis has been made. Because disease modifying therapy is expensive, has potentially fatal side effects and the onset of debility can be delayed for years, many patients elect not to start disease modifying therapy or choose to discontinue therapy shortly after starting. The purpose of this paper is to explore ways to increase medication compliance.
Multiple sclerosis is a chronic autoimmune disorder in which the body’s immune cells attack the protective myelin sheath surrounding nerves which leave plaques or scars that

Of this total, sixty percent was attributed to direct cost and forty percent was attributed to indirect costs, which includes lost wages and early mortality. The impact of Multiple Sclerosis on life expectancy is negligible, a decrease of five to fifteen years, however, quality of life can be significantly impaired as a result of disability, depression and cognitive impairment. Currently, there is no cure for Multiple Sclerosis but there are several medications currently available that are proven to prevent the frequency of exacerbation. I have chosen to categorize these medications by their route of administration; injectable, oral and

Currently there are three medications, Teriflunomide, Fingolimod and Dimethyl Fumarate. While these medications offer the convenience of a pill they have considerable and potentially dangerous side effects. Teriflunomide (Aubagio) works by blocking the enzyme dihydroorotate dehydrogenase, which inhibit rapidly dividing cells like those of the immune system. Serious side effects include inability to fight infection, breathing problems and high blood pressure. Other side effects include: headache; diarrhea; nausea; hair thinning or loss; and abnormal liver test results. Fingolimod (Gilenya) is a sphingosine-1-phosphate receptor modulator. Serious side effects are potentially fatal infections, bradycardia and, hemorrhaging focal encephalitis. Currently, two patients have died while taking Gilenya, although it is not clear if the drug was solely responsible. Dimethyl Fumarate (Tecfidera) belongs to a class of drugs called Nrf2 activators and may work by decreasing inflammation thus preventing nerve damage. Tecfidera may cause serious side effects, including allergic reactions and has been implicated in the death of one patient who developed Progressive Multifocal Leukoencephalopathy (PML). The most common side effects of Tecfidera include flushing and stomach