Science Stories

Multiple Sclerosis Spasticity: Exploring an Often-Overlooked Symptom

Multiple sclerosis (MS) is a chronic, inflammatory and neurodegenerative disease of the central nervous system, affecting nearly one million people in the United States.1,2 Typical MS symptoms include fatigue, mood disorders, changes in cognitive function or memory, sensory changes (numbness, pain, vibrations), motor changes, vision changes and bladder or bowel dysfunction.3

One of the most common motor symptoms, spasticity, often manifests as involuntary muscle stiffness and/or spasms, occurring in more than 80 percent of people with MS.4,5 However, MS spasticity doesn’t end there, and this symptomatic domain – which is often invisible to others – can also include pain, sexual dysfunction, dysarthria, fatigue, depression and anxiety, mobility impairment, bladder and bowel dysfunction, and sleep disturbances.5-8

“The best way I can describe spasticity is that your muscles feel as if they’re made of rubber bands that are being stretched to their capacity and stay that way,” said Chernise, a patient who was diagnosed with MS in 2016. “It’s a tightness that wouldn’t go away on its own.”

MS spasticity can be incredibly disruptive on a person’s life, with 33 percent of patients in one study reporting the need to modify or eliminate common daily activities due to their symptoms.9 Additionally, MS spasticity is often undiagnosed and can be left untreated, as only about half of patients reported receiving pharmacotherapy for spasticity.10

“I’ve always been an athletic and active person and had tight muscles. To me, this was just part of my story – who I was,” said Sarah, who was diagnosed with MS in 2008. “That’s why it was so hard for me to accept that the next-level pain and discomfort I was experiencing was related to MS spasticity.”

Although several new medical advancements have been developed for MS in recent years, there is still a large unmet need when it comes to resolving spasticity symptoms, as 43 percent of people with MS spasticity have reported not achieving adequate relief with current treatment options.5 Despite limited advancements in this area, many people living with MS believe that treating the symptoms of MS is equally as important as treating the underlying condition, as symptomatic remediation can contribute considerably to the quality of their daily lives.11,12

At Jazz, we are committed to pursuing novel advancements in order to develop therapeutic options that address significant unmet patient needs. MS is one such therapeutic area that we are focused on with our research and development efforts, by evaluating how our leading GW Platform may help people living with MS manage their spasticity symptoms.

References:

  1. Montalban X, Gold R, Thompson AJ, et al. ECTRIMS/EAN guideline on the pharmacological treatment of people with multiple sclerosis. Mult Scler. 2018;24:96–120.
  2. Wallin MT, Culpepper WJ, Campbell JD, et al. The prevalence of MS in the United States: A population-based estimate using health claims data. Neurology. 2019;92(10):e1029-e1040.
  3. Ziemssen T. Symptom management in patients with multiple sclerosis. J Neurol Sci. 2011;311 Suppl 1:S48–52.
  4. Abboud H, Macaron G, Yu XX, et al. Defining the spectrum of spasticity-associated involuntary movements. Parkinsonism Relat Disord. 2019;65:79-85.
  5. Bethoux F, Marrie RA. A cross-sectional study of the impact of spasticity on daily activities in multiple sclerosis. The Patient-Patient-Centered Outcomes Research. 2016;9(6):537-546.
  6. Milinis K, Tennant A, Young C, Group TS. Spasticity in multiple sclerosis: associations with impairments and overall quality of life. Multiple Sclerosis Related Disorders. 2016;5:34-39.
  7. Henze T, Flachenecker P, Zettl U. Importance and treatment of spasticity in multiple sclerosis: results of the MOVE 1 study. Der Nervenarzt. 2013;84(2):214-222.
  8. Rusz J, Benova B, Ruzickova H, et al. Characteristics of motor speech phenotypes in multiple sclerosis. Multiple Sclerosis Related Disorders. 2018;19:62-69.
  9. Rizzo M, Hadjimichael O, Preiningerova J, Vollmer T. Prevalence and treatment of spasticity reported by multiple sclerosis patients. Multiple Sclerosis Journal. 2004;10(5):589-595.
  10. Tintoré M. Advances in the management of multiple sclerosis symptoms: pathophysiology and assessment of spasticity in multiple sclerosis. Neurodegenerative Disease Management. 2015;5(6s):15-17.
  11. Henze T, Feneberg W, Flachenecker P, et al. [What is new in symptomatic MS treatment: Part 2-gait disorder and spasticity]. Nervenarzt. 2017;88(12):1428-1434.
  12. Newsome, S. et al. Symptom Burden and Treatment Goals of People with MS Spasticity: Results from SEEN-MSS, a Large-scale, Self-reported Survey. Presentation SXM10. Presented at Consortium of Multiple Sclerosis Centers (CMSC) annual meeting.