Comparison of Pharmaceutical Effect of Alemtuzumab and Natalizumab and Their Side Effects in Treatment of Various Stages of Multiple Sclerosis Patients.

Abstract

BACKGROUND\nMultiple sclerosis (MS) is an autoimmune and inflammatory disease in which the body mistakenly attacks the myelin, the sheath of nerve cells in the brain and spinal cord, causing ulcers. This damage to myelin disrupts the transmission of neural messages to the nervous system. This study aimed to compare the pharmacological effect of Alemtuzumab and Natalizumab in treating various stages of MS patients and the side effects of their use. Autologous hematopoietic stem cell transplantation has also been studied as the best current treatment for MS.\n\n\nMETHODS\nIn this study, 425patients with MS were examined and categorized into different groups according to their disease stages. Among the people studied, 183 were men, and 242 were women. Patients with primary progressive MS (PPMS) has divided into groups A and B, patients with relapsing-remitting MS (RRMS) in groups C and D, and patients with secondary progressive MS (SPMS) in groups E and F. According to the classification, Alemtuzumab drug prescribed for patients in groups A and C and E, and Natalizumab for B and D and E groups. To more accurately examine patients condition, a criterion called the large-scale disability status was defined, calculated before and after treatment. Hence, the relationship between the number of head magnetic resonance imaging with the lesions created in patients, recurrence time, and recurrence rate before and after treatment investigated.\n\n\nRESULTS\nThe EDSS the coefficient was significantly lower in RRMS patients than in PPMS and SPMS patients. After 12 months of treatment, The EDSS coefficient of RRMS patients treated with Natalizumab was significantly lower than patients treated with Alemtuzumab. Also, which was the difference between this coefficient before. Moreover, after treatment was significantly higher, Alemtuzumab, this result indicates the direct effect and a positive function of Natalizumab in this group of patients. Due to Natalizumab s use, the recurrence rate of RRMS-D was significantly lower than that of RRMS-C. After 12 months of treatment, there was a significant decrease in the lesion s number on magnetic resonance imaging of the head and the RRMS-D group time of recurrence.\n\n\nCONCLUSION\nAccording to the results, the efficacy of Natalizumab in treating RRMS patients was better than Alemtuzumab, while there were no significant differences between other stages of MS patients. Also, the autologous hematopoietic stem cell transplantation method is more effective than Alemtuzumab and Natalizumab to use as the best treatment for patients with MS can give a theoretical and clinical guide for various stages of MS treatment and provide them to specialists.