How Multiple Sclerosis Is Treated

Now that you finally have a name -- multiple sclerosis -- to match the symptoms that have been plaguing you, you've probably got a lot of questions about how to treat those symptoms and keep your condition from getting worse. Although researchers haven't yet discovered a cure for MS, there are many effective medications to help manage your disease. Your doctor will work closely with you to find the treatment that works best for you while causing the fewest side effects.

Here is a rundown of your MS treatment options.

Changing the Course of Your MS: The Disease-Modifying Drugs

If you have active relapsing-remitting MS, your doctor will first treat you with one of the disease-modifying drugs. They're called disease-modifying drugs because they can actually slow down the progression of MS and prevent relapses to keep you active for longer. These drugs work by suppressing the immune system so that it doesn't attack the protective coating (myelin) surrounding the nerves.
Disease-modifying drugs that reduce the number of flares include:

• interferon beta 1b (Betaseron, Extavia)
• glatiramer acetate (Copaxone)

Disease-modifying drugs that have been shown to reduce flares and slow progression of MS include:

• interferon beta 1a (Avonex, Rebif)
• teriflunomide (Aubagio)
• fingolimod (Gilenya)
• mitoxantrone (Novantrone)
• dimethyl fumarate (Tecfidera)
• natalizumab (Tysabri)

Both the interferon drugs and Copaxone are considered to be very safe. Most of the side effects that do occur stem from the injection itself, including redness, warmth, itching, or dimpling of the skin over the injection site. With the interferon drugs, it's common to have flu-like symptoms --aches, fatigue, fever, and chills -- but these should fade within a few months. The interferon drugs can also slightly increase your risk for real infections by lowering the number of white blood cells that help your immune system fight off illnesses.

There are three oral drugs available to treat the relapsing form of MS. Aubagio is a once-a-day tablet. The most common side effects of Aubagio include diarrhea, abnormal liver tests, nausea, and hair loss. However, Aubagio does carry a “black box” warning -- the FDA’s most serious warning -- because of liver problems and birth defects. Doctors should periodically do liver function testing in those on the drug. The medication should not be taken by pregnant women.  

Gilenya is another once-daily tablet for relapsing MS. Before you can take this drug, you'll need to have a chickenpox vaccine if you haven't already had chickenpox. That’s because during a clinical study one person died from chickenpox while taking Gilenya. Gilenya's most common side effects include headache, diarrhea, back pain, cough, and abnormal liver tests. Because Gilenya may cause a slow heart rate, your doctor will watch you closely after your first dose. In August 2013 the FDA said it was investigating a man in Europe who  developed a rare but sometimes fatal brain disease called progressive multifocal encephalopathy (PML).
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