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I caught part of a cable television program but I ended up falling asleep but it seemed interesting (I was just exhausted). Basically it talked about chemotherapy being a so-far proven treatment for Multiple Sclerosis (not sure at what stage or where in the world it was).

I did some searches on the search function on Health.SE and I couldn't find anything on the topic of MS and chemotherapy as a treatment so I figured I'd ask here to see if others can put out some good information on it.

Question

Is there any truth behind chemotherapy actually curing Multiple Sclerosis (short-term or long-term) that's been done to humans? Are there any specific facilities, clinical trials, treatment centers, etc. that one with this condition may use for a good starting point about availability to them.

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    Health.SE might not have much on this, but a quick glance shows that google is not lacking. – Carey Gregory Feb 19 '16 at 2:49
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    I think that downvoters wanted you to include more research from outside health SE, but many questions do get away without research. Furthermore, the less you know about a specific topic, the more difficult it is to search for answers. I'd say it is a legitimate question. – Lucky Feb 19 '16 at 15:14
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    There are two upvotes and two downvotes, so there's no consensus on your question. (None of the 4 votes are mine.) Although I would have liked to see a little more research, I don't think it's a bad question. I, for one, learned something. – Carey Gregory Feb 19 '16 at 16:20
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    Some sites require it and others don't. Stackoverflow, for example, will close questions that show no effort on the OP's part. Health seems to fall somewhere in the middle. I think prior research is desirable but I've never seen a question closed for lack of it. – Carey Gregory Feb 19 '16 at 17:32
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    Nobody actually says how reliable the resource you found for your question has to be, so if you could remember the name and the producer of the show that might constitute research on your behalf. After all, you didn't just invent/hypothesise that chemotherapy might be used for MS, you've heard about it somewhere. Of course, the rest of the community may not share this opinion, it's just a suggestion. – Lucky Feb 19 '16 at 18:11
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Is there any truth behind chemotherapy actually curing Multiple Sclerosis?

Unfortunately, no. Multiple sclerosis (MS) is a chronic illness - meaning that it cannot be completely cured. There are, however, various therapeutic options for patients suffering from MS. Some of them include chemotherapeutics - but not as the first-line treatment.

The important thing to understand is that there are many forms of MS, which can roughly be categorised in four groups:

  1. Relapsing - remitting (RR)
  2. Primary progressive
  3. Progressive relapsing
  4. Secondary progressive

Severity, clinical manifestations and treatment options differ across these types. The most common type is RR.


RR therapeutic approach

For RR there are two sorts of treatment:

  1. Treatment in an acute relapse, where short-term corticosteroid treatment is used to stop the attack
  2. Disease modifying treatment - which is used regularly in order to reduce the frequency and severity of relapses, and improve prognosis.

It is the second group, where chemotherapy can be used, but, as mentioned above not as a first-line treatment. This means that other therapeutic options should be tried first. These are predominantly glatiramer acetate or interferon beta. If they don't work some other medicines are considered. Only if they don't work either, the next option is using chemotherapeutic agents.


How would a chemotherapeutic work in MS?

There are, again two approaches. The first one is to use these medicines, at lower doses than to treat cancer, to suppress the immune system. Since MS is an autoimmune disease, immune suppression reduces the inflammation and damage to the myelin sheet. Another approach is to use these medicines to ablate the immune system prior to autologous stem cell transplant, where the patient's bone marrow is replaced with their stem cells. This line of treatment is, however, still in experimental phase and has not been approved. There are many complications, difficulties and side-effects of this procedure, and thus far the risks outweigh the benefits.


Examples

Some sorts of chemotherapeutic agents that have been used or tested for MS:

  • Cladribine has been tested for MS and even approved in some countries, but after it was rejected by the FDA and EMeA on the basis of lacking evidence for benefits outweighing the risks, the manufacturer stopped marketing applications, since new clinical trials would be costly.

  • Cyclophosphamide has also been investigated. Efficacy in aggressive form of disease was reported, but so were some serious adverse effects. Further research in necessary, and official guidelines, such as those by the National Institute for Health and Care Excellence (NICE) do not recommend use of cyclophosphamide in MS treatment.

  • Methotrexate has shown no significant efficacy in primary progressive MS, and was less effective than interferon beta in RR.


References:

Drug Therapies for Relapsing-Remitting Multiple Sclerosis

Recommendations for Drug Therapies for Relapsing-Remitting Multiple Sclerosis

Multiple Sclerosis: A Primary Care Perspective

Treatment Optimization in MS: Canadian MS Working Group Updated Recommendations

A Placebo-Controlled Trial of Oral Cladribine for Relapsing Multiple Sclerosis

Merck: Regulatory Update on Cladribine Tablets

Interventions affecting disease progression: cyclophosphamide should not be used in patients with multiple sclerosis (because research evidence does not show beneficial effects on the course of the condition).

Effects of low dose methotrexate on relapsing-remitting multiple sclerosis in comparison to Interferon β-1α: A randomized controlled trial

Methotrexate for multiple sclerosis

Hematopoietic stem cell therapy for multiple sclerosis: top 10 lessons learned.

  • Heh, I had just started writing an answer saying pretty much the same things :-) – YviDe Feb 21 '16 at 19:54
  • @YviDe I'm sorry :-(. But if you have another/simpler phrasing (my answers tend to be a bit verbose) or other references, please do post. It will be beneficial for the users, and we don't exactly have the best answer per question ratio as a site. – Lucky Feb 21 '16 at 19:56
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    @1Fish There were some rather bombastic headlines regarding this type of research. I, personally, find that quite unethical - promises of 'miraculous' effects by the journalists (and not scientists) gives false hope to the patients and their families. Furthermore, when a reliable, well known therapeutic option is working, it is against common sense to go for a more risky one. And killing off the immune system and establishing it again is rather risky. – Lucky Feb 21 '16 at 20:07
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    It's rather like those giant headlines about curing HIV. Killing the whole immune system with chemotherapy and then replacing it with a bone marrow transplant from one of the people immune to it is interesting, but nothing we can do for millions of people. – YviDe Feb 21 '16 at 20:11
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    @1Fish_2Fish_RedFish_BlueFish It's not just the risks of chemotherapy, it's the risk of killing the immune system - those patients are very susceptible to infection, and also how exactly the immune system will be when it has rebuilt is never 100% sure. I agree that it's a promising procedure, but in MS the risks outweigh the benefits. In cca 10% of the patients another, different autoimmune disease develops after the transplant. (Thanks for the formatting tip :-)) – Lucky Feb 21 '16 at 20:20

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