新藥給了MS病人新的希望 By Iris Winston , For Canwest News Service
“Today, there is a huge urgency to make the diagnosis because we know that early and aggressive treatment can alter the course of the disease,” says MS specialist and University of Alberta assistant clinical professor Dr. Brad Stewart. “Back 15 or 20 years, diagnosis was less urgent because we had nothing to offer the patient.”
過去的15~20年來, 因為診斷的不積極導致治療的失敗, 其實早期的發現和積極的治療有機會治癒.
Then, says Dr. Ruth Ann Marrie, the director of the multiple sclerosis clinic of the University of Manitoba Health Sciences Centre, “treatment largely focused on acute management of relapses — those times when people presented with sudden worsening of symptoms like vision loss, limb weakness or numbness. We tried to help them manage some of the chronic symptoms like fatigue and difficulty in walking.
大多的治療都關注在解決復發的問題; 視力喪失; 下肢無力; 或麻痺; 疲累等症狀
“We didn’t have medication that we thought could alter the long-term course of the disease.”
In 1995, the first drug treatment that could modify the disease was approved. Shortly afterwards, three more drugs of the Interferon type were added. In 2006, a fifth drug was approved.
“All five” — Avonex, Betaseron, Copaxone, Rebif and Tysabri — “are drug therapies that attenuate the disease by helping control the intensity and frequency of attacks,” says Stewart Wong, the Multiple Sclerosis Society of Canada’s media and public relations national senior manager.
Avonex, Betaseron, Copaxone, Rebif and Tysabri這些藥物只能夠控制復發的頻率和降低強度
“When you treat MS earlier with some of these disease-modifying therapies, the course of the disease is easier to manage and you have a better quality of life…. The mid-1990s opened the way to a sustained period of hope and progress in medicine, the course of research and how people can live with the disease.”
But Vancouver MS specialist and former medical director of the city’s MS clinic Dr. Stanley Hashimoto says the impact of the therapies introduced in the mid-90s was relatively modest.
“Their impact was exaggerated significantly through a lot of marketing,” he says.
“We needed something that had an actual benefit in terms of therapy and disease modification.”
Dr. Paul O’Connor, the multiple sclerosis program director of St. Michael’s Hospital, Toronto, and president of the Canadian network of multiple sclerosis clinics, agrees “these drugs have modest effectiveness, but their introduction in 1995 did mark the advent of a new era (in MS treatment).”
The next generation of drugs is looking even better, says Stewart.
“All the years of research are really bearing fruit. We may not have a cure yet, but if you can get someone to go into remission 90 or 95 per cent of the time, that’s a whole lot better than we have now. And we have also had some advancement in how we treat secondary progressive MS. We now have an oral medication that works up to 70 per cent of the time to treat exacerbations.”