Drug Therapies

The safety of stopping any DMD safely is different in every individual case, so this decision should not be taken without medical advice. There is limited scientific research into this topic, but one study found that younger people have a higher risk of returning MS activity when stopping DMDs than older people with MS.

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Yes, but there are preparations that you should make before setting off so that you save yourself unnecessary hassle on the journey.  When going through any security checkpoint, it is advisable to have plenty of information about your DMDs and any additional equipment available.

You can do this by having a letter from your doctor about your medication, and keeping all original labelled packaging to hand.

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There are currently 12 DMDs licensed for use in the UK, but there are always new treatments emerging. Some of the most commonly used disease-modifying drugs are: Copaxone, Gilenya, Lemtrada, Tecfidera and Tysabri. People with MS can also take interferons.

These treatments vary in effectiveness, in terms of relapse rate reduction and slowing of disability accumulation. Generally the more effective the drug, the worse the risk of side-effects and other significant health problems developing as a result of treatment.

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Interferons are proteins which are made by the body to reduce inflammation. However, people with MS can also take manmade interferons – this is done with an injection pen between every other day and every two weeks.

Interferon treatment is less effective than some of the newer DMDs, reducing relapse rates by about a third, but the side-effects can be debilitating.

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Each DMD is taken differently – although some can be consumed as tablets, others can only be administered by injection or infusion. Taking tablets daily is, generally, more popular amongst people with MS than having an injection daily, due to both its ease and the preference of some people to not use needles.

There can also be a small chance of an injection site reaction such as swelling or itching. Some of the newer, more effective, DMDs require regular intravenous infusions in hospital as often as once a month.

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When considering the use of a disease-modifying drug (DMD), there are various factors that someone with MS should consider, including:

  • How effective the drug is,
  • Its track record of safety,
  • How much it costs,
  • How it can be taken (i.e. as a tablet or injection),
  • How often it should be taken,
  • Whether or not medical check-ups are required,
  • Severity of side-effects – the more potent the DMD, generally the stronger the side-effects

DMDs should not be relied on in the long-term, or used alone in place of wider lifestyle changes such as improving diet and exercise. If considering a DMD, people with MS should always see a medical expert to get an informed opinion on whether or not the treatment is right for them.

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In this video, Dr Jonathan White talks about Copaxone, other disease-modifying drugs and how to stop them.

Jonathan has also answered a series of other frequently-asked questions, which you can see here

Dr Jonathan White talks through what people with multiple sclerosis should expect when using a private doctor for a B12 injection.

Jonathan has also answered a series of other frequently-asked questions, which you can see here

Injecting medication manually is best, rather than with the automatic devices. It is important to warm the syringe to body temperature first by holding it in your clenched hand for a few minutes. It is also important to pinch a piece of skin and lift it up before injecting into it. Medicine injected with the skin flat often goes too deep.

To avoid site reactions with sub-cutaneous injections, it is important to use the correct injection technique. In the video below, Professor George Jelinek shows how to inject correctly.

Many people injecting sub-cutaneous (SC) medication for MS develop site reactions, like lumps, wheals, itching, redness or bruising. This is usually due to injecting too deep (into muscle) or too shallow (into the skin itself).

The right place for the medication to go is just below the skin, in the space between the skin and the underlying muscle. This space is really hard to find reliably if the skin is stretched out during injection. Picking an area where there is some fat under the skin such as the abdominal wall, the skin needs to be grasped between thumb and middle finger and lifted.

The needle is then introduced perpendicular to the top of that wad of skin and inserted all the way to the hub. If using an autoinjector, set the depth at maximal depth, as lifting that piece of skin guarantees the injection will not go to deep with a standard needle like the one on the Copaxone injection. Inject relatively slowly, as rapid injection causes pain, and once injected, remove the needle quickly, and let go of the skin.

Dispose of the syringe and needle thoughtfully. Most people do not require heat or cold packs with this technique, and very few develop any site reactions.

This video demonstration below was performed at one of the Gawler MS Retreats and shows the correct technique.

 View the video here