Disease Modification - National Multiple Sclerosis Society

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Disease Modification

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Overview

Relapsing-remitting MS is thought to be primarily an inflammatory disease of myelin in the CNS. The disease process is characterized by periodic relapses followed by complete or incomplete recovery. Simultaneously, however, irreversible axonal damage and transection are known to occur (Trapp et al., 1998). Controlling inflammation early in the disease may also reduce the damage to axons (Coyle, 2008). The medications that are currently available to treat MS appear to be most effective during the early, inflammatory phase of MS, becoming less potent as the disease transitions to a more neurodegenerative process.

Since 1993, eleven medications have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of relapsing forms of MS (Jeffery, 2013). The information presented here is designed to allow a side-by-view of medication options without suggesting inter-medication comparisons, except where specifically supported by the results of head-to-head clinical trials. Comparing the efficacy of medications across trials is misleading because of key differences in the populations, outcome measures, and statistical analyses used in the studies.

Eleven FDA-approved disease-modifying therapies (DMTs)

Ten medications are FDA-approved for the treatment of relapsing forms of MS. Of these, five are delivered by injection, three are oral and two are is by infusion.

Injectable options

Oral options

Infused options

MS Coalition Evidence-Based Consensus Paper on DMTs

The Multiple Sclerosis Coaltion has published an evidence-based consensus paper entitled The Use of Disease-Modifying Therapies in Multiple Sclerosis: Principles and Current Evidence. A Consensus Paper by the Multiple Sclerosis Coalition. This document was developed and endorsed by the eight Coalition member organizations, and subsequently endorsed by the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS). The paper is designed to: summarize current evidence about disease modification in MS;  highlight the importance of early and ongoing treatment; and provide support for broad access to FDA-approved MS disease-modifying therapies for people with MS in the United States. A companion summary paper for general audiences is currently under development.

FDA-approved DMTs – a bird's eye view

Emerging Therapies Collaborative

The Society has joined with other MS organizations to provide authoritative, evidence-based resources for clinicians and patients regarding the benefits and risks of newly-emerging FDA-approved medications.  Click here for more information.

Drug development pipeline

Read about compounds currently under investigation for therapeutic use in MS.

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