Dimitri Cachia has been living with MS, a condition that affects the brain and spinal column, for more than eight years.
“I do find it difficult to get around as easily as a normal person. I find it especially challenging in crowds, in a rush, walking several hundred metres,” he says.
“There are a lot of challenges, but you learn very quickly to live with them and just find a way to get on with life.”
One of those challenges is finding a treatment that works for each individual patient.
Current medications are aimed at trying to reduce the immune response against antigens in the nervous system.
“They don't improve anything on a day-to-day basis,” says Cachia. “They prevent things from getting worse.”
Dr Arun Krishnan, a consultant neurologist at the University of New South Wales, says because the condition can affect patients differently, it's important there are a range of treatment options available.
“We think there are lots of different immune mechanisms that go wrong in MS, and each of these selects a different method of action in the nervous system,” he says.
The first oral treatment arrived in Australia 18 months ago, giving patients an alternative to daily injections and monthly infusions for the first time, but it isn't suitable for all patients.
Jeremy Wright, Chief Executive of MS Research Australia, says the arrival of Aubagio (Teriflunomide) will allow more of the estimated 21,000 people currently living with MS in Australia to benefit from an oral drug.
“We welcome the neurologists and the patients having another option,” he says. “A further option so the neurologists can be more specific about the treatments they prescribe for particular patients.
"An oral treatment is obviously more convenient for people say, in the workforce."
While Aubagio has been approved by the Therapeutic Goods Administration for prescription in Australia, it is currently under consideration for subsidy. For the moment, it is still an expensive option for patients.
“Treatments for MS currently cost between 10 and 30,000 dollars a year; a cost that is reduced dramatically if the drug is added to the Pharmaceutical Benefits Scheme,” says Mr Wright.
Dr Krishnan says many patients who take oral medications for MS "feel it improves their quality of life".
“Many of them have taken injectable treatments before, and are very aware of the fact that they have MS.”
“It's easy, in a sense, to forget that you have the disease, to get on with your life, if you're able to take an oral treatment rather than an injectable treatment.”
Like its predecessor, Gilenya (Fingolimod), Aubagio won't be suitable for all patients.
“All medications have side effects and the oral treatments are no exception to this,” says Professor Krishnan.
“The other thing is all new drugs need to establish a profile of safety and efficacy over many years of treatment, and that's something they still have to establish for these drugs.”
Dimitri Cachia says he welcomes less obtrusive treatment options, but he would also like to see the development of medication that does more than “prevent things from getting worse.”
“It'd be fantastic to have my normal life back. It'd be fantastic to walk more, to go for a run, to be able to dance as good as I used to dance,” he says.
“To have all the other issues gone, or better. None of the drugs on the market purport to do that.”
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