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Monday Medical: Infusion therapies provide relief for neurological conditions

Susan Cunningham
For Steamboat Pilot & Today

From multiple sclerosis to severe migraines, various neurological issues can be treated through infusion therapies.

Dr. Tracy Vargas, a neurologist at UCHealth Neurology Clinic in Steamboat Springs, outlines how infusion therapies work for several common issues below.

Infusion basics

Through infusion therapy, medication is delivered directly into a patient’s vein. Infusions allow medications to be absorbed more fully and quickly, and are necessary for medications that cannot be taken orally.



“The absorption is faster as it does not have to bypass digestion,” Vargas said. “There is less breakdown of the medication, making it more available. And there is an ease of administration — oftentimes, it can be easier for a patient to get an IV infusion once every six months and not worry about forgetting medications or missing doses.”

Locally, infusion treatments can be done at UCHealth Jan Bishop Cancer Center.



Multiple Sclerosis

“We have a significant MS population, and a lot of the newer disease-modifying therapies are through IV infusions,” Vargas said.

Patients with an aggressive form of the disease may begin with the most potent therapies, such as intravenous B-cell therapies, which target the white blood cells causing nerve damage. This therapy is given every six months and is only available through infusions. For treating acute attacks, infusions of steroids may be helpful.

“When treating MS attacks acutely with steroids, there’s pretty good evidence that IV treatment with steroids is better than oral steroids,” Vargas said. “It works faster at reducing acute symptoms.”

Migraines

Patients may sometimes get into a migraine cycle that is difficult to break. When that happens, infusion treatments of several medications that address nausea, inflammation and other symptoms can help.

“If they cannot get out of a severe headache, we will coordinate with the infusion clinic to give a multi-modal treatment quickly to help them break that cycle,” Vargas said. “When it’s given through an IV, it’s absorbed faster and acts quicker.”

Peripheral neuropathies

In these conditions, the body’s immune system attacks the protective covering — or myelin sheaths — of peripheral nerves, causing damage. Examples include Guillain-Barre Syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP).

Patients with certain types of demyelinating neuropathies may benefit from infusion treatments of immunoglobulin therapies. An infusion of immunoglobulins, which are also known as antibodies, can disrupt the immune system’s attack of nerve cells.

“The immunoglobulin therapy may help calm down the acute autoimmune attack,” Vargas said. “Sometimes, one treatment can stabilize the condition and possibly be curative. Other times, it’s chronic, so you need to continue the treatments monthly or every two to three months.”

Other conditions

Infusion therapies are helpful for other conditions, including rheumatological conditions, such as rheumatoid arthritis, osteoporosis and lupus.

At the infusion clinic

If you need an infusion therapy, your health provider will submit clear orders before you arrive.

“All the patient has to do is show up to their appointment — the orders have been approved, and the medications are on hand, so treatment can be administered quickly while patients relax in their chair and enjoy the views of the ski mountain,” Vargas said.

An infusion can take from one to six hours, depending on the medication. Medical professionals are available, so any adverse reactions, such as nausea, hives or a headache, can be addressed quickly.

“This is a really good resource for the neurology clinic and the rheumatology clinic,” Vargas said. “It is vital to have an infusion clinic to make treatment easy and streamlined.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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