Managing the Disease Course

Several medications called disease-modifying treatments (DMTs) or disease-modifying drugs (DMDs) have been shown to be effective in decreasing the frequency of relapses or exacerbations and decreasing the development of lesions or plaques in the brain or spinal cord.1

Disease-modifying treatments

Disease-modifying therapies have been shown to reduce the frequency and severity of MS attacks, or relapses. DMTs can slow the accumulation of MS lesions in the brain and spinal cord and can slow the progression of disability. There are several DMTs approved by the U.S. Food and Drug Administration (FDA) for the treatment of MS which are listed in the table below. Only one – Ocrevus™ (ocrelizumab) – is approved to treat primary progressive MS (PPMS), as well as relapsing forms of MS.1-3

Many of these medications are considered to be first-line options, in other words, the initial choice of drug therapy for treating patients who are diagnosed with MS. Others are second-line drug treatment options in the US, which means that they are reserved for people who have not responded adequately to first-line drugs.

Disease-Modifying Treatments for MS

DRUG
INDICATION
ADMINISTRATION
Betaseron® (interferon beta-1b)
Relapsing forms MS
Subcutaneous injection
Avonex® (interferon beta-1a)
Relapsing forms MS
Intramuscular injection
Rebif® (interferon beta-1a)
Relapsing forms MS
Subcutaneous injection
Extavia® (interferon beta-1b)
Relapsing forms MS
Subcutaneous injection
Plegridy® (Peginterferon beta-1a)
Relapsing forms MS
Subcutaneous injection
Copaxone® (glatiramer acetate)
Relapsing forms MS
Subcutaneous injection
Tysabri® (natalizumab)
Relapsing forms MS
IV infusion
Lemtrada® (alemtuzumab)
Relapsing forms MS; generally second-line
IV infusion
Ocrevus™ (ocrelizumab)
Relapsing or primary progressive MS
IV infusion
Tecfidera® (dimethyl fumarate)
Relapsing forms MS
Oral
Aubagio® (teriflunomide)
Relapsing forms MS
Oral
Gilenya® (fingolimod)
Relapsing forms MS
Oral
Novantrone® (mitoxantrone)
SPMS or relapsing forms MS
IV infusion

How do you choose between different disease-modifying therapies?

With so many disease-modifying-therapies available, it is important to know the differences between these drugs so that you and your doctor might select one over another for your treatment. Some of the drugs described above are indicated (approved for a specific use) as the initial or first-line treatment for persons with MS and/or CIS. Others are second-line treatment options for persons who have not responded adequately to a first-line drug.4-17 In some cases, the choice among drugs is made according to the following considerations:

  • Side effects associated with each
  • MS disease course, as some drugs may be more effective than others in one disease course versus another
  • Lifestyle considerations, such as whether a person is able to give him or herself an injection
  • Desire to become pregnant, as some drugs are not recommended during pregnancy
  • Insurance coverage
Written by Emily Downward | Last review date: April 2018.
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