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Disease Modification

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In this article

Overview

Multiple sclerosis (MS) is a disorder of the central nervous system (CNS) characterized by inflammation, demyelination and degenerative changes that can lead to functional loss and disability.

Most people with MS experience relapses and remissions of neurological symptoms, particularly early in the disease, and relapses are usually associated with new inflammation in the CNS. Over time, there are fewer relapses and less new inflammatory activity with the disease process becoming more progressive.  There is a large body of evidence that supports early and ongoing treatment with an approved disease modifying therapy as an evidence-based approach to reducing new relapses, delaying progression of disability and limiting new inflammation in the CNS.

FDA-approved disease-modifying therapies (DMTs)

The FDA has approved more than a dozen agents for the treatment of relapsing forms of MS.  One has also been approved for primary progressive MS with another for secondary progressive MS. Routes of administration include:

Injectable (subcutaneous and intramuscular)

Oral

Intravenous

MS Coalition Evidence-Based Consensus Paper on DMTs

The Multiple Sclerosis Coalition 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.

American Academy of Neurology Practice Guidelines for the Use of DMTs

In April 2018 the American Academy of Neurology (AAN) published practice guidelines for the use of disease modifying therapies for adults with multiple sclerosis. These guidelines have been endorsed by the National MS Society and Multiple Sclerosis Association of America. The guidelines address starting, switching and stopping disease modifying therapies for adults with clinically isolated syndrome, relapsing-remitting MS and progressive forms of MS. The full guidelines and summaries are available for clinicians and patients.

Guideline: Disease Modifying Therapies for Multiple Sclerosis - American Academy of Neurology

For most people, it’s better to start taking drugs for multiple sclerosis (MS) early on rather than letting the disease run its course, according to a new guideline for treating MS from the American Academy of Neurology.

Drug development pipeline

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

Additional resources

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