Questions to Ask Your Doctor About Monoclonal Antibodies for Multiple Sclerosis
Monoclonal antibodies are one of the newer options to treat MS.
Having an autoimmune disease like multiple sclerosis (MS) means the immune system is mistakenly attacking the body’s own healthy tissue.
“In the case of MS, it's a condition in which the immune system really targets the central nervous system, the brain and the spinal cord,” says Asaff Harel, MD, neurologist and Director of the Multiple Sclerosis Center at Lenox Hill Hospital, Northwell Health.
That’s where monoclonal antibodies (MABs) come in. You may have heard of them in the ongoing efforts tocombat long-term effects of COVID-19 and even in the context of migraine treatment.
What do I need to know about monoclonal antibodies for multiple sclerosis?
Monoclonal antibodies are a type of immunotherapy. Immunotherapies help your body’s own immune system to treat an illness. Monoclonal antibodies for MS target a certain specific receptor on an immune cell. This ideally helps stop the immune system from attacking the central nervous system (CNS).
“MABs tend to be usually a very effective treatment for MS, oftentimes with a good tolerability and safety profile,” says Dr. Harel. “They classically have been administered as infusion medications, but there's an injectable form these days.”
One benefit of monoclonal antibodies is that the side effects are generally mild and tolerable. That’s because they’re very targeted, so they only work on the parts of the body that are causing MS.
What are questions to ask your doctor about monoclonal antibodies for MS?
Here’s a handy list of questions to go to your doctor’s office with. They can answer them tailored to your condition, the severity of your symptoms, and your unique treatment plan. Come prepared with questions like:
How do I take the drug?
How often do I need to take the drug?
How often do I need to visit for monitoring and tests?
How much will each medication cost me?
Why are you recommending this to me?
Having this discussion will indicate how you will have to adjust your lifestyle in order for the treatment to be effective, set your expectations of your personal responsibility in treatment, and build rapport and trust in your doctor.
Why are monoclonal antibodies a reason to be optimistic?
Turns out, 10 years can make a huge difference in the development and improvement of MABs. Several are in development that should be even safer and more tolerable.. Studies are showing that MABs can be an early, effective treatment of MS, potentially preventing or delaying challenging disabilities.
Plus, doctors now have the first treatment for primary progressive MS. This is a subtype of the condition that affects more than 10 percent of the MS population. This form has typically been tougher to treat because people don’t experience relapses to react to, but rather chronic symptoms that get continuously worse.
What’s more, researchers are also exploring new MABS that could possibly repair the damage to the central nervous system that patients have already developed. This could basically “rewind” the progression of MS and reduce disability. This means future therapies could not only help prevent damage, but undo it.
- Asaff Harel, MDAsaff Harel, MD, is a Neurologist specializing in multiple sclerosis and related neuro-immunological conditions, serving as the Director of the Multiple Sclerosis Center at Lenox Hill Hospital, Northwell Health.
References
Voge, N. et al. (2019) Monoclonal antibodies in multiple sclerosis: present and future. Biomedicines.
Helliwell, C. et al. (2009).Monoclonal antibodies in multiple sclerosis treatment: current and future steps. Therapeutic Advances Neurological Disorders.
Multiple Sclerosis Trust. (2023).Monoclonal antibodies.
Steinman, L. et al. (2018). Monoclonal antibody therapy in multiple sclerosis. Practical Neurology.
Nguyen, A. et al. (2017). Monoclonal antibodies in the treatment of multiple sclerosis: emergence of B-cell-targeted therapies. British Journal of Clinical Pharmacology.
National Multiple Sclerosis Society. Treating MS.