Multiple sclerosis, for 3 out of 10 patients, uncontrolled disease

Multiple sclerosis, one of the most common and serious diseases of the central nervous system, is kept ‘under control’ in 7 out of 10. For 30% of patients it is therefore necessary to improve the diagnostic-assistance process. To reduce the severity of symptoms, it is essential to guarantee, especially during the pandemic, timely therapeutic intervention and scrupulous adherence to treatment by the sick. Despite these undoubted successes, the disease still seriously undermines the quality of life of patients as it alters communication between the brain and the rest of the body. Symptoms and course vary and range from vision problems to cognitive impairments to fatigue and difficulty walking. Furthermore, in Italy the total number of patients is increasing: there are more than 3,400 new cases a year (one diagnosis every 3 hours). This is what the specialists underline during an online media-tutorial dedicated to the disease, promoted by Celgene, now part of Bristol Myers Squibb. “Today we have more than 20 drugs available, many of which are called ‘disease modifiers’ because they act on our immune system and can reduce attacks and slow down the progression of the disease”, recalls Francesco Patti, Aou Policlinico Vittorio Emanuele, University of Catania, Multiple Sclerosis Center. “In the last three years, new therapies have also been introduced for the progressive forms of multiple sclerosis. They guarantee good results but they confirm that we are not yet able to completely control the disease. This is because we do not yet have well-sharpened weapons, especially for those more serious cases where the disease does not show periods of remission. In addition, rehabilitation interventions are necessary for 55% of patients “. The possibilities of guaranteeing a decent quality of life – continues the specialist – depend very much on the early intervention that can be ensured. Before the pandemic, an average of 30-40 days elapsed from the time of diagnosis to the start of therapy. Covid-19 has partly complicated the situation, especially during the most difficult months of 2020. Despite the stress test that our NHS has been undergoing for over a year, we have ensured the administration of treatment despite some inevitable postponements and delays. This is due to the good organization and excellent quality of the multiple sclerosis centers active in Italy, considered among the best in the world “.” Another problem is that of adherence to the therapy prescribed by the specialist – adds Claudio Gasperini, medical director of the Department of Neuroscience Ao San Camillo-Forlanini in Rome -. As for oral drugs, only 75% of patients take them correctly after one year following medical indications. The phenomenon is also found for injection therapies that worry about side effects and methods of administration. As is well known, the pandemic has made access to health facilities more difficult and has caused some clinical checks to be skipped. The patient then tends not to communicate to the attending physician the lack of adherence to the treatments. A frankly worrying phenomenon is thus growing and can nullify the successes we have achieved thanks to years of scientific research “. Multiple sclerosis (MS) is a chronic, unpredictable and progressively disabling disease. It is estimated that there are over 126,000 people with MS in Italy and the average annual social cost per patient is around 45,000 euros. It affects women in greater numbers, in a ratio of 2 to 1 compared to men, and mostly begins between the ages of 20 and 40. “It is a chronic disease and as such requires adequate care in the various stages of the disease and periodic monitoring by the neurologist and other health professionals involved in the treatment”, concludes Mario Alberto Battaglia, president of the Italian Multiple Sclerosis Foundation. These controls can also be guaranteed through new digital tools that were in part already tested before the pandemic “.” Covid-19 highlighted the shortcomings of our assistance network, especially at the local level. One in four patients, among those who needed it during the pandemic – he reports – highlighted difficulties in accessing psychological support and rehabilitation. In fact – argues Battaglia – all those socio-health activities that are not attributable to specialized centers such as home care, rehabilitation or psychological assistance, both remotely and in presence, in particular for the most serious, must be strengthened. facilitate the process for the recognition of disability. Finally, the relationship between neurological specialists and the professionals of the territorial medicine team must always be guaranteed “, he concludes.