Keeping multiple sclerosis under control means reducing the severity of symptoms and slowing the progression of disability. In fact, although scientific research has achieved many successes in the treatment of this nervous system disease, which affects over 126 thousand people in Italy, multiple sclerosis is a condition that 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. If even before the pandemic adherence to therapies was considered a critical aspect in the chronic management of patients, the Covid emergency has made this aspect even more important: today 3 out of 10 patients are unable to keep the disease under control and therefore need of a better diagnostic-assistance path.
“Today we have more than twenty 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”, underlined Francesco Patti, of the AOU Policlinico – Vittorio Emanuele , University of Catania, Multiple Sclerosis Center, during an online media-tutorial dedicated to the disease, promoted by Celgene now part of Bristol Myers Squibb. “In the past three years, new therapies have also been introduced for the progressive forms of multiple sclerosis. They guarantee good results but confirm that we are not yet able to fully control the disease. This happens because we do not yet have well-sharpened weapons especially for those more serious cases where the disease does not present periods of remission ”.
Adhesion alarm
“Another problem is that of adherence to the therapy prescribed by the specialist”, added Claudio Gasperini, Medical Director of the Department of Neuroscience AO San Camillo-Forlanini in Rome. “As for oral drugs, after one year only 75% of patients take them correctly 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 “.
Rehabilitation, even remotely
55% of people with MS need rehabilitation, a service that is not yet guaranteed uniformly across the country. Motor rehabilitation has a direct effect on neuronal plasticity and is therefore essential both for improving symptoms and for slowing the progression of the disease. To this can be added the cognitive rehabilitation which has been shown to obtain good results in preserving the health of neurons. “Covid-19 highlighted the shortcomings of our assistance network, especially at the territorial level. One in four patients, among those who needed it during the pandemic, showed difficulties in accessing psychological support and rehabilitation ”, concluded Mario Alberto Battaglia, President of the Italian Multiple Sclerosis Foundation. “In fact, all those socio-health activities that are not attributable to specialized centers such as home care, rehabilitation or psychological assistance, both remotely and in the presence, in particular for the most serious, must be strengthened, as well as facilitating the path for the recognition of disability. Finally, the relationship between neurological specialists and the professionals of the territorial medicine team must always be guaranteed ”.
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