Although there is still no cure for MS, effective strategies are available to modify the disease course, treat exacerbations (also called attacks, relapses, or flare-ups), manage symptoms, improve function and safety, and provide emotional support. In combination, these treatments enhance the quality of life for people living with MS.
Medications for Modifying the Disease Course
The following agents can reduce disease activity and disease progression for many individuals with relapsing forms of MS, including those with secondary progressive disease who continue to have relapses.
FDA-Approved Disease-Modifying Agents
- Aubagio (teriflunomide)
- Avonex (interferon beta-1a)
- Betaseron (interferon beta-1b)
- Copaxone (glatiramer acetate)
- Extavia (interferon beta-1b)
- Gilenya (fingolimod)
- Novantrone (mitoxantrone)
- Rebif (interferon beta-1a)
- Tecfidera (dimethyl fumarate)
- Tysabri (natalizumab)
Resources
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Disease Management Consensus Statement (.pdf)
Recommendations and principles from the Society’s National Clinical Advisory Board for health care professionals and people with MS—to guide treatment with the disease-modifying drugs.
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The MS Disease-Modifying Medications (.pdf)
A booklet describing the approved use, dosage and route of delivery, side effects, benefits, and available support programs.
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Patient Assistance Programs
A listing of the pharmaceutical company financial assistance programs to help manage the costs of the drugs.
Adherence
Adhering to your treatment plan is the best possible strategy for managing your MS—and continuing the disease-modifying medication your doctor has recommended for you is an important part of that plan.
Treating Exacerbations
An exacerbation of MS is caused by inflammation in the central nervous system (CNS) that causes damage to the myelin and slows or blocks the transmission of nerve impulses. To be a true exacerbation, the attack must last at least 24 hours and be separated from a previous exacerbation by at least 30 days. However, most exacerbations last from a few days to several weeks or even months. Exacerbations can be mild or severe enough to interfere with a person’s ability to function at home and at work. Severe exacerbations are most commonly treated with high-dose corticosteroids to reduce the inflammation.
Managing Symptoms
In multiple sclerosis, damage to the myelin in the central nervous system (CNS), and to the nerve fibers themselves, interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption of nerve signals produces the symptoms of MS, which vary depending on where the damage has occurred. MS symptoms can be effectively managed with a comprehensive treatment approach that includes medication(s) and rehabilitation strategies.
Promoting Function through Rehabilitation
Rehabilitation programs focus on function—they are designed to help you improve or maintain your ability to perform effectively and safely at home and at work. Rehabilitation professionals focus on overall fitness and energy management, while addressing problems with accessibility and mobility, speech and swallowing, and memory and other cognitive functions.
Rehabilitation is an important component of comprehensive, quality health care for people with MS, at all stages of the disease. Rehabilitation programs include:
- Physical Therapy
- Occupational Therapy
- Therapy for Speech and Swallowing Problems
- Cognitive Rehabilitation
- Vocational Rehabilitation
The Role of Complementary and Alternative Medicine (CAM)
CAM includes everything from exercise and diet to food supplements, stress management strategies, and lifestyle changes. These therapies come from various disciplines and traditions—yoga, hypnosis, relaxation techniques, traditional herbal healing, Chinese medicine, macrobiotics, naturopathy, and many others. They are referred to as complementary when they are used in conjunction with conventional medical treatments and alternative when they are used instead of conventional treatments.
Treatment Updates
FDA Approves Twice a Day Capsules Called Tecfidera™ (formerly called BG-12) for Relapsing MS
Mar 27, 2013
The FDA has approved Tecfidera™ capsules (dimethyl fumarate, Biogen Idec –formerly “BG-12”) as a first-line disease-modifying therapy for people with relapsing forms of MS. This makes the third oral therapy approved for relapsing MS, and the tenth disease-modifying treatment available in the U.S. Tecfidera is expected to be available by prescription within a few days.
Ginkgo Fails to Improve Cognitive Function in People with MS
Sep 24, 2012
Results of a placebo-controlled, 12-week clinical trial were recently published, showed that Ginkgo biloba failed to improve cognitive function in people with MS. The study involved 121 people with all types of MS whose cognitive tests showed some cognitive impairment. After 12 weeks, no differences were seen between those on Ginkgo and those taking placebo in any of the outcome measures. The study was not designed to determine the long-term impact of Ginkgo. The results were published online on September 5, 2012 in the journal Neurology.
FDA Approves Oral Teriflunomide – Brand Name Aubagio® – as Disease-Modifying Therapy for Relapsing MS
Sep 12, 2012
The U.S. FDA has approved teriflunomide once-daily pills (Aubagio) to treat relapsing forms of MS. This is the second oral disease-modifying therapy approved for the treatment of multiple sclerosis. The therapy is expected to be available for prescription by October 1, 2012 in the U.S.
UPDATE on Tysabri and PML
Aug 16, 2012
As of April 2, 2013 there have been 347 confirmed cases of progressive multifocal leukoencephalopathy (PML, a viral infection of the brain that usually leads to death or severe disability) among people who have used Tysabri® (natalizumab, Biogen Idec) after it became available for prescription in July 2006.
Ampyra Post-Marketing Study Results Announced - Low dose does not improve walking: Approved dose misses primary endpoint but shows benefit in several secondary endpoints
Aug 14, 2012
A post-marketing study of Ampyra® (dalfampradine-ER, Acorda Therapeutics) did not meet its primary endpoint, showing that a low dose (one-half of the approved dose) did not improve walking speed. The dose approved by the U.S. Food and Drug Administration (FDA) to improve walking in MS did not meet this endpoint in this study either, but did improve walking speed and endurance based on several secondary measures.