The Multiple Sclerosis Patient Journey - Episode 5
A patient shares the treatments she has received for multiple sclerosis.
June Halper, MSN, MSCN: Ann, when you first started your journey with MS [multiple sclerosis], were you put on a disease-modifying therapy? I think you mentioned 1989 and we know that was one of the early years before therapy started. I think it was 92, right, Dr. Coyle?
Patricia K. Coyle, MD: 1993 for interferon beta-1b.
June Halper, MSN, MSCN: 3, yeah.
Ann Moore: I was diagnosed in 1989 and I conferred with you and Dr. Geiser, and it was determined that I have MS. But, at that point, they had no therapies out. I have to be honest, I thought for the first 10 years they made an incorrect diagnosis. I was fine. I had nothing wrong with me. No numbness, no tingling, no weakness, no anything. And then 10 years later I’m like, “Oh, something’s not right here.” I was having a, unbeknownst to me, a thoracic exacerbation. I called over to the MS Center, at that point Dr. Cohn was there, went over to see you folks, and you said, “Annie, here are the therapies that are out. I know you; I would suggest that this is the one you go on, but I suggest that you also do some research on your own and see if you concur with me.” I was very happy at your suggestion and for 15 years I was on Copaxone and I thought it was a magnificent drug. I still think it’s a good drug. Just after 15 years it ran its course and I had to switch therapies.
June Halper, MSN, MSCN: I know Copaxone had minimal side effects, but the injection every day, how’d you handle that?
Ann Moore: I went on, when you had the powder and you had to mix it with the solution and rub it between your hands.
June Halper, MSN, MSCN: Yeah. Remember that, Dr. Coyle?
Ann Moore: No auto injects or anything like that. Kathy had to do four of the injections because I couldn’t reach them. You know what, needles don’t bother me, so I did not have a problem in doing that. I mean, I do have divots in all seven locations right now and will for the rest of my life, but it’s OK.
June Halper, MSN, MSCN: Well, Kathy didn’t seem to mind. Right, Kathy?
Kathy Zelles: No. Never.
June Halper, MSN, MSCN: Are you on therapy now, Ann?
Ann Moore: I am on Rituxan. I had been on Rituxan now for a couple years, so, as a matter of fact, I go, I believe it’s in February, that I go for a Rituxan infusion. Yeah, Dr. Williams, the doctor that I go to right now at the International MS Center is very good because he can juggle. As he said, “Ann, I have a lot of cocktails.” I mean, over the years, yeah, I was on, but even before I went on Copaxone, I did IVIG for 10 months. I’ve done Tysabri a couple times. But for the last three or four years it’s been methotrexate injections and Rituxan.
June Halper, MSN, MSCN: Dr. Coyle, any comments about Ann’s therapy?
Patricia K. Coyle, MD: Well, rituximab [Rituxan] is a chimeric anti-CD20 monoclonal antibody therapy. It is not approved by the Food and Drug Administration (FDA) for MS but clearly has significant off-label use in Sweden. Kaiser Permanente, I understand it’s their go-to MS drug. It’s much cheaper. We have two FDA approved anti-CD20s, in humanized and human for MS, but rituximab is much cheaper. I think it’s a very reasonable alternative, high-efficacy agent, even though it’s never going to be approved for MS.
June Halper, MSN, MSCN: Well, it seems like your journey with MS and medications, Ann, has been an interesting one and it seems that.
Ann Moore: Yeah, I’ve gone through the gamut.
June Halper, MSN, MSCN: You are very proactive.
Ann Moore: Yeah. I am my mother’s daughter. My mother had this, we would have put it on her headstone if we could have, “Can do.” I can do it and that’s how I feel.
June Halper, MSN, MSCN: Where was she born?
Ann Moore: Well, she was born in New York City.
June Halper, MSN, MSCN: So, there you go.
Ann Moore: Absolutely.
June Halper, MSN, MSCN: Right, Dr. Coyle, Dr. Foley, right? The New Yorkers …
Patricia K. Coyle, MD: Can do.
June Halper, MSN, MSCN: I want to thank you all for watching and joining us at this NeurologyLive® Cure Connections®. If you enjoyed this program, please subscribe to the e-newsletter to receive upcoming information about other programs. I’d like to thank you all for the time and I thank you all for this wonderful opportunity and hope to see you all again.