Below, Dr. Stuart describes the balancing act of choosing an MS treatment plan, and the role that the development of antibodies plays in making that plan.
What are antibodies?
WILLIAM STUART, MD: Antibodies are protein substances that the body develops in response to some offending antigen (a different substance), whether it's outside the body or inside the body. The antigen provokes the body's response to develop an antibody, which then protects the body.
What is the concern about the interferon medications creating antibodies?
The concern is that these neutralizing antibodies will render the drugs ineffective in controlling the disease.
The medications we use to treat MS -- with the exception of Copaxone - are interferons, which produce antibodies. The body recognizes the drugs as foreign substances that it doesn't want there. And the drugs that we have available -- Betaseron, Avonex and Rebif, all of which are interferons - have varying degrees of antibody production. These range from about 40-45% in Betaseron to 25% in Rebif and 2-5% in Avonex.
How do these antibodies develop?
The injection of a substance, such as an interferon, into the body, can stimulate the body to produce antibodies by other cells in the body. It is like coming into contact with a virus, which stimulates the immune system to react and create antibodies. Once those antibodies are there, the capacity for them to be there -- even though they may change in levels from time-to-time -- is permanent.
