Mechanisms Behind New Multiple Sclerosis Medications

Neurologist Andrew D. Goodman, MD, FAAN, explains the benefits of the mechanisms behind the new multiple sclerosis (MS) medications.

Firstly, teriflunomide, fingolimod, and dimethyl fumarate can all be administered orally, which Goodman says provides greater convenience for MS patients and, thus, improves their medication compliance. Additionally, the drugs’ solubility transports them to the central nervous system (CNS), in contrast to “other large, protein-based molecules and biologics such as interferon and the infusible drugs such as natalizumab (that), for the most part, to our knowledge, are not getting into the CNS,” Goodman points out.

Beyond crossing the blood brain barrier, fingolimod may produce a “beneficial effect on the type of cells that make myelin, which is critical tissue that is attacked in MS,” Goodman describes. Furthermore, dimethyl fumarate is believed to have “tissue protective effects on the nerve fibers themselves, which seem to deteriorate possibly because of stresses on their oxidative metabolisms,” Goodman notes.

By and large, the new MS agents offer “a different way of working on the immune system and modulating the immune system that is aimed at trying to control the process without overdoing it,” Goodman concludes.