Longtime runner Annie Saunders didn’t let a 2021 diagnosis of multiple sclerosis sideline her passions.
If anything, the 40-year-old Irwin native pushes harder — through weakness and imbalance caused by the neurological disease — to keep her body strong.
Saunders remains hopeful because she believes a cure will be found in her lifetime.
“I feel the research is promising,” she said. “I think there is real potential.”
Saunders could be right.
A new class of medications in late-stage clinical trials show favorable, if preliminary, results, according to Allegheny Health Network neurologist Troy Desai.
Bruton’s Tyrosine Kinase, or BTK inhibitors, are designed to reduce ongoing nerve damage by permeating the blood/brain periphery.
Clinical studies have been underway for more than five years.
It is possible that one of the drugs could be approved as early as this year.
“These medications can’t reverse damage, but they can slow down progression or possibly halt it altogether,” said Desai, of Highland Park.
What is MS
Multiple sclerosis is an autoimmune disease that attacks the brain, spinal cord and optic nerves. It damages myelin, or the protective covering around nerve fibers.
The result is scarring that manifests as lesions. They cause weakness, balance problems, vision changes, fatigue, numbness and bladder/bowel dysfunction.
Medical treatment is highly effective on the most common form of the disease, called relapsing-remitting MS. Patients don’t often develop severe disabilities.
But for people with secondary progressive MS, a condition where symptoms gradually worsen, drugs don’t work as well.
Slow progression is driven by chronic lesions with low levels of inflammation difficult to detect with an MRI.
“These are patients that can’t pinpoint when they started to feel worse,” Desai said. “Maybe they used to be able to cut the grass in one day and now it takes them longer. They can’t get around like they used to.
“For these patients, traditional meds do not affect these cells very much, partly because they are in the brain. Some of the traditional meds don’t cross the blood/brain barrier.”
The new class of drugs could be a game changer. They would address one of the largest unmet needs in MS care.
Good prognosis
For Saunders, who now lives in Avalon, the potential breakthrough offers hope.
Her symptoms began about five years ago with “weird” sensations in her legs.
“I don’t have pain, but my legs feel heavy or weak,” she said. “It’s hard to explain. I can’t feel a poke in the leg like I can feel it in the arm.”
MS impacts more than 1 million people in the United States, most prevalently in the Northeast, according to the National MS Society.
The illness can develop at any age but most people receive diagnoses between 20 and 50.
There’s no way to pinpoint the cause.
“There isn’t one single cause of MS,” Desai said.
It’s believed to develop from a combination of genetic susceptibility and environmental factors — things like smoking, viral exposures and vitamin D deficiency have all been linked to increased risk.
“But no one factor explains why one person develops MS and another does not,” Desai said.
Saunders has never smoked but was exposed to second-hand smoke as a child. She has a family history of autoimmune disease and labs also showed she was deficient in vitamin D.
“But it also might just be that I drew a bad hand,” she said.
While the medical world awaits a breakthrough, the best advice to keep symptoms at bay is to live a healthy lifestyle, according to the Cleveland Clinic.
Suggestions include: limit alcohol, follow a Mediterranean diet, eliminate smoking, increase exercise and prioritize sleep.
“Keep your mind and body active,” said Desai, who had a longtime office in Brackenridge before moving it to Fox Chapel. “Attack it on all fronts.”
Since her diagnosis, Saunders has ruled out long footraces and turned her attention to walking. She’s training for her third Pittsburgh Half Marathon, scheduled for May 3.
An editor for news website Morning Brew, Saunders receives infusions twice a year to help manage her symptoms. She also undergoes an annual MRI to monitor disease activity.
Her condition has remained stable, with no new lesions.
“My diagnosis was a shock but I feel incredibly lucky,” she said. “MS is a serious diagnosis, and you don’t really know what the future looks like when you first hear it.
“It’s part of my life, but it doesn’t define it.”