What Specialty Pharmacists Need to Know About Multiple Sclerosis

Although there are more than 2 million people living with multiple sclerosis (MS), it is relatively uncommon to hear about these patients.1 But those who suffer from MS and their caregivers are aware of this debilitating autoimmune disease each day. They cope with the struggles that, for some, will only worsen over time. MS is a chronic and progressive disease that is growing in prevalence, without an apparent reason. It is estimated that about 200 people in the United States are diagnosed with MS each week.² March is MS awareness month.

Epidemology

MS is most commonly diagnosed between age 20 and 50, with the first symptoms occurring between 30 and 35. MS occurs about twice as frequently in women as in men.³ A unique characteristic of MS is the global geographic trend. In general, the prevalence of MS is highest in areas further from the equator. Caucasians and people of Northern European descent are at greatest risk of developing MS compared with other ethnicities.³

Pathophysiology

MS is an autoimmune disease that destroys the myelin sheath surrounding the axon of nerve cells. Demyelination contributes to a wide variety of adverse effects associated with MS, such as fatigue, gait abnormalities, neuropathy, and visual disturbances.4 Without a specific diagnostic test for MS, it is often difficult to diagnose. Having health care professionals familiar with this disease is critical to early detection and slowing the disease progression.1 The most common way to evaluate MS is by obtaining a magnetic resonance imaging of the brain. This detects the hallmark lesions associated with MS but is often not done until a patient first has symptoms associated with the disease, known as a clinically isolated syndrome. These lesions most commonly occur in the brain, spinal cord, and optic nerves.

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