Live better with Multiple sclerosis

The number of MS patients wäfirst of all, rapidly. Thanks to new drugs you have a good chance of a long time without serious Einschräto live on. But there are risks

When Jutta H. wants to forget their disease, engrossed in other worlds, or sports in the water

Aqua aerobics is your wöchent­of favorite date. Jutta H. (54) pulls her blue swimsuit with the türkisfarbenen flowers and descends gently up the steps into the pool. In the warm water, you can forget about your disease. How hard you Go fällt. Your fear of falling. The total Erschöadded to a normal working day. That you might need sometime in a wheelchair.

It started with Stüshorten the

Now Jutta is concentrated in the swimming pool of a school in DüDusseldorf only on the instructions of the trainer. They marched vorwärts, rückwärts, on the tips of the toes. "In the water füeverything feels easier an", the woman says.

Difficulty walking were the first Symp­tome that she noticed. On your way to work, she was several times gestürzt – from unerklänatural Grü. "I had the Gefühl, to me hätte have someone lead in the legs pumped." In April 2017, a neurologist made the diagnosis: Multiple sclerosis (MS).

Increasing Numbers

With this disease of the nervous system zäJutta hlt to a rapidly größhe expectant group of Pa­tien­th. Within six years, according to the Central Institute für the Kassen­ämedical care, an increase of 29 percent. In the year 2015, more than 223&thinsp nationwide;000 legally in the outpatient Insured being treated for MS. For comparison: in 2009 there were around 172 000.

This increase has probably two Gründe. First, it became much easier, the disease quickly and unambiguously. "Frühere there were a lot of people without a Diagnose", Professor Heinz Wiendl, Director of neurology at the University hospital of M&uuml says;window.

On the other, experts believe that verächanged environment – and ­­Living conditions play a role. "This is the Hygiene hypothesis: The später comes, the immune system, with infections in contact, the more likely it is to react in an inappropriate way darauf", ­erklärt Professor Bernhard Hemmer Director of the Neurological clinic of the Technical Universität MüMunich.

Chamäleon, with many variants

In MS, the immune system attacks its own nerve cells and their Hücases. As a result, the Signal&uuml is;transmission gestört. It usually affects young people between the ages of 25 and 39, women are two to four times hämore often than Mämen.

Practitioner to describe MS as a Cha­mäleon, as a disease with a thousand faces. Some patients, for example, have only a one-Time complaints, for example, a Entzüthe invention of the optic nerve or Taubheitsgefühle in the arms and legs. Then spüyou ren for decades, or even never some of the nervous disorders.

Heavy Verläufe möpossible

The other Extreme: The MS schlägt so violent, that the person needs after one or two years in a wheelchair. "In the case of the großen a majority of the patients can prevent this stage today, however, or at least many years or decades hinausgezögert werden", Professor Hans-Peter Hartung, Director of the clinic f&uuml says;r neurology at the Heinrich-Heine-Universität Düsseldorf. MS is not curable, but the continued heavy braking can be stopped below, in the best case, even.

Frühere diagnoses

Thanks to research and treatment, there are to be recorded in MS a huge success. "With today’s Möopportunities köwe can patients much more individualized and better service than before 20 Jahren", neurologist Wiendl said. For example, the diagnosis is made much faster and, accordingly, with the treatment started.

Üabout the Situation in front of all these progress reports, Gabriele K. (57). "I had for many years, the Gefühl, that with me something is not right." Dizziness, malaise and spots before the eyes, toiled, but the Ädoctors found no cause. As of 2009, the diagnosis of MS, received the educator of the medicines. However, the Beta-Interferon, the injected every second day, called Schüttelfrost and fever. Soon it no longer seemed sufficient. Another drug sold Gabriele, because of serious side effects in other patients gehört had. "I was like a Guinea pig gefühlt."

Progress by monoclonal Antiköbody

In the 90s, licensed Beta-interferons were the first drugs, the Häfrequency and Severity of MS-Schübe able to reduce. Now daf&uuml are;r 13 different active ingredients to Verfü. Among the newer Präreadily available are so-called monoclonal Antiköbody, the the immune system strong verächange. They are more effective than previous drugs – but also more unpredictable.

The substance is Natalizumab, for example, erhöht in certain patients the risk für a gefädangerous brain infection. A therapy with Alemtuzumab carries the risk that problems with the Schilddrüse or the kidneys.

Außbesides, not all of the newer substances long-term risks are foreseeable. "Because of this uncertainty, many patients and also &Auml be shy;doctors in front of it. But on the other hand, what relates to the control of the MS, often for a very long time Ruhe", expert Wiendl said.

Infusion, the hope makes

Especially the jüthe youngest new arrival, the Antiköbody Ocrelizumab, awakens große hopes Ädoctors and patients. It is the first officially-approved substance, which is also in the rare creeping Form of MS shows success. Get affected no Schübut her condition worsens from the beginning, continuously. Also Jutta is suffering from this variant of the disease. In the context of a Härtefall program was the new drug is very früh test.

Already a year before the admission to the first Infusion was in her Köthe body and handle of the B-cells of your immune system, which play in MS, an important role. "Then it went to me super", they reported – and hopes that the remains still for a long time. Also, your attending physician, Dr. Jonas Graf from the University hospital Düsseldorf, äußert a positive effect: "The patient is stable, her condition has not deteriorated further."

So far, the creep was at the end of, or highly active MS often – if the insurance company of the person Concerned, approved – with the non-für is the therapy approved active ingredient Rituximab treated. Instead of the admission of this already bewäto work inability to substance, developed by the manufacturer, however, the very äsimilar drug Ocrelizumab.

There are still many question marks

The möoffset gains in the lucrative market with the new MS drugs seem to have played a role. "The Standard dose Rituximab für a MS therapy costs about 6000 euros in the year, in the case of Ocrelizumab, there are 33 000 Euro", neurologist inhibitors from M&uuml says;Munich.

In the studies of Ocrelizumab little side effects comparatively. But außhe is a lighter Anfämaturity für various infections were chest, for example, cancer-Fälle observed. If the substance is really a erhöelevated tumor rate, müshot further investigation klären. "The long-term consequences of the therapy are still not sure abzuschätzen", inhibitors emphasized. The erh&ouml should;hte risk of cancer is not bestätransparent, köcould be administered, the Infusion patients with less severe progression of the disease.

Spätfolgen not yet known

Also für heavy Fälle of the schubföshaped MS with cladribine, a new therapy option. But für this Präthe Council of Europe in the form of tablets, the long-term side effects are currently impossible to predict. Neurologist inhibitors: "The drug should only, therefore, at high Krankheitsaktivität be used."

However, the variety of the Verfüaside the drugs makes the treatment of Multiple sclerosis only better – but also more complex. Für Diseased, it may be important that your doctor the Möopportunities tatsätake full ausschöpft. "I see the größte Herausforderung", Wiendl from the University hospital M&uuml says;window. The doctor and the Patient mübiggest together, the risk-Benefit Verhäratio abwägen. Often wüauthorities have long bewägranted, but schwächer effective medication used – and the disease ließe do not control optimally.

Advice in the specialists

Expert Wiendl rät patients, and a specialist MS neurologist to advise and to treat, regelmäßto go ig for the control and the therapy may be.

The Problem: At the outbreak of the disease läabsch&auml sst hardly;will appreciate how they developed. Currently a lot of research about how the individual course is better before k&ouml be said;could. "If clear from the beginning wäre that a Patient can expect disabilities, wäre the decision easier to start immediately with a very effective drugs and where side effects to akzeptieren", doctors inhibitors says.

Relaxed, everything is easier

What köcan MS patients even Good für do? Experts recommend healthy Ernäcurrency, adequate exercise and restful sleep. Dafür that special Diäthe course of the disease k&ouml affect;can, there is no evidence. In any case, Smoking and &Uuml should;mountain villain to be avoided, both begüsupports the continuation of suffering. Many patients also take Vitamin D, because a positive influence is suspected.

Jutta H., and Gabriele K. have found their own way, with MS cope: avoid Stress and schöne of the things genießen. You spüren, you Köbody pressure still works significantly worse. "As soon as I Stress, I Füße no longer hoch", Gabriele says. Therefore, it is currently not – as well as Jutta: "I can now tackle everything alone. This relaxes me very much." You are engrossed in detective novels and computer games. And every Tuesday Aqua aerobics is in the calendar.

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