Modifying the Disease Course
The Food and Drug Administration (FDA) has approved more than a dozen medications for the treatment of relapsing forms of MS. One medication is approved for primary progressive MS and one is approved for secondary progressive MS. In addition, several are approved for individuals who have experienced their first neurological symptoms called clinically isolated syndrome known as CIS. Research has shown that all the MS medications can
- reduce the number of relapses (also called attacks or exacerbations)
- limit new MS activity (new areas of damage called plaques or scars) in the central nervous system (CNS) and seen on magnetic resonance imaging (MRI)
- slow disease worsening (progression)
Years of research suggest that starting one of these medications soon after the diagnosis of MS is the most effective way to manage the MS disease process. These MS medications modify the MS disease course and are also known as disease-modifying treatments (DMT).
Of these medications, most are self- injected - (Avonex®, Betaseron®, Copaxone®, Extavia®, Glatopa® 20 mg and 40 mg, Glatiramer Acetate 20 mg and 40 mg, Plegridy®, and Rebif®). Three are by mouth (Aubagio®, Gilenya® and Tecfidera®), and four are infusions (Lemtrada®, Novantrone®, Ocrevus®, and Tysabri®).
Novantrone® is FDA-approved for people with worsening relapsing-remitting MS (worsening in between relapses) and those with secondary progressive MS (started with relapses but are now worsening with no or few relapses). This DMT is used infrequently due to serious side effects and risks. Ocrevus®, was approved for the treatment of relapsing-remitting MS and primary progressive MS (progression without relapses since symptom onset). Zinbryta® was approved by the FDA in 2016, but withdrawn by the manufacturer due to risks in March of 2018.
Because of safety concerns, the FDA recommends that Lemtrada® should generally be reserved for patients who have had an inadequate response to at least two other disease-modifying therapies.
The MS disease-modifying treatments have side effects and risks that are different from everyone. Starting a DMT or switching to a different DMT are decisions best made by the person with MS and his or her MS doctor, after a conversation about how the medication is taken, the side effects, risks and cost.
Read more in The MS Disease-Modifying Medications (.pdf). Injection fatigue information is not available on our website.