My friend's MS symptoms had been improving until she started Gilenya 4 months ago. Is there any reason to think that Gilenya might be causing the decline?
The role of any of the disease modifying therapies (DMTs), including Gilenya, is to do 3 main things:
- Cut down on the frequency of MS relapses,
- Cut down on the number of new scars on the MRI over time, and
- Slow down the permanent accumulation of disability. The success of any DMT is measured by the MS specialist. By and large, patients are generally unable to determine this by themselves. Where the confusion lies is in fluctuating "symptoms" of MS that can be misinterpreted by patients as MS relapses or permanent disability. These fluctuating symptoms can be omnipresent (at varying levels of severity), and at times can go away spontaneously.
Healthcarejourney.com has a wealth of information on various symptoms of MS and practical ways of managing those symptoms as they occur. I'd encourage your friend to browse this information, and then discuss with their specialist.
In order for your question to be answered definitively, your friend will need to ask their MS specialist. If the specialist determines that Gilenya is appropriately managing those 3 items mentioned above, then the main issue may be fluctuating symptoms of MS that may require an added, but temporary, treatment plan to address the symptoms. Keep in mind, that it may be simply too early (only 4 months) to determine the effectiveness of Gilenya for your friend. Regardless, symptoms can be managed in the meantime, by your friend's physician.
A. Scott Nielsen MD MMSc
Virginia Mason Multiple Sclerosis Center