Multiple sclerosis (MS) is a chronic neurological condition that affects the central nervous system, leading to symptoms that can vary widely in severity and progression. One of the most common concerns for people diagnosed with MS is how the disease and its treatments might affect their life expectancy. The question of whether MS drugs influence life expectancy is complex and depends on many factors, including the type of MS, the specific medication used, and individual patient characteristics.
MS drugs, often called disease-modifying therapies (DMTs), are designed primarily to reduce the frequency and severity of relapses (flare-ups) and to slow the progression of disability. These drugs do not cure MS but aim to modify the disease course. By controlling disease activity, DMTs can help maintain neurological function for longer periods, which can indirectly influence life expectancy.
For example, drugs like Mavenclad (cladribine) have been shown to significantly reduce the number of relapses and slow disability progression over a period of years. Patients on Mavenclad experienced fewer MRI lesions and longer relapse-free periods compared to those on placebo. This suggests that by controlling disease activity, such drugs can help preserve neurological function and potentially improve long-term outcomes. However, Mavenclad also causes a reduction in lymphocyte counts, which can increase susceptibility to infections, a risk that needs to be managed carefully during treatment.
Similarly, Ocrevus (ocrelizumab) and its subcutaneous form Ocrevus Zunovo are used to treat both relapsing and primary progressive forms of MS. Clinical studies have shown that Ocrevus can delay disability progression and reduce relapse rates. Importantly, in people with primary progressive MS (PPMS), Ocrevus has been shown to delay the need for a wheelchair by several years. Since mobility and independence are closely linked to overall health and survival, this delay can positively impact life expectancy. However, these drugs can cause side effects such as respiratory infections, which require monitoring and management.
Life expectancy in people with MS is generally somewhat reduced compared to the general population, often by about 6 to 7 years on average. This reduction is influenced by the type of MS, with primary progressive MS often associated with a shorter life expectancy than relapsing-remitting forms. The main causes of death in people with MS tend to be related to complications such as infections, cardiovascular disease, or other common causes rather than MS itself being directly fatal.
The introduction of DMTs has changed the outlook for many people with MS. By reducing relapses and slowing disability progression, these drugs help maintain a better quality of life and may contribute to narrowing the life expectancy gap. For instance, delaying significant disability can reduce the risk of complications like infections or immobility-related problems, which can shorten life expectancy.
Some treatments, like simvastatin, have been investigated for their potential neuroprotective effects in MS, but results have been mixed or negative, and such drugs are not currently standard MS therapies. Other newer drugs like Zeposia work by modulating the immune system to reduce inflammation and nerve damage, which may also help slow disease progression.
It is important to note that while MS drugs can improve disease outcomes, they also carry risks, including side effects and increased vulnerability to infections due to immune system modulation. These risks must be balanced against the benefits, and treatment decisions are highly individualized.
In summary, MS drugs do not directly extend life expectancy by curing the disease, but by controlling disease activity, reducing relapses, and slowing disability progression, they can help maintain neurological function and reduce complications that might shorten life. This can lead to an improved quality of life and potentially a longer lifespan compared to untreated MS. Ongoing research continues to improve these therapies, aiming to further enhance both life expectancy and quality of life for people living with MS.
