| Click on the links below for detailed descriptions of each drug, it's usage and possible side effects. |
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Therapy of Acute Relapses The most frequently used and the most important treatment is the use of glucocorticoids or corticosteroids such as prednisone (orally) or intravenous (IV) methylprednisolone. Studies and clinical practice suggest that steroids will hasten recovery from a relapse in the majority of patients. In general, IV corticosteroids are used for major relapses and oral prednisone is used for relatively minor relapses. However, physicians differ widely in their prescription practices of corticosteroids and other regimens are frequently used. No data exist regarding the optimal duration of therapy but corticosteroids are generally given for no more than a few weeks to avoid potential serious side effects of long term treatment. - Considering the side effects of the corticosteroids, mainly in case of repeated use (osteoporosis, etc.) presently we recommend corticosteroids only if the attack is severe enough to interfere with the individual's function.
- Milder attacks are treated symptomatically.
Immunomodulatory Therapy Avonex (interferon- beta-1a, intramuscular), Betaseron (interferon –beta –1b), and Copaxone (glatiramer acetate), and Rebif (interferon- beta-1a, subcutaneous) are first line disease modifying therapies (DMT’s) that are approved by the FDA for the treatment of relapsing-remitting (RR) MS. Treatment with one of these agents is indicated as soon as possible after the diagnosis of relapsing-remitting MS is made (excluding pregnant women). MS specialists also may advocate the use of these agents before a definite diagnosis of MS is made, after the first clinical manifestations of demyelinating disease, the so called clinically isolated syndrome (CIS). Alternatively one can wait for a definite diagnosis of MS after the second clinical event or with new findings on MRI of the brain or spinal cord. Tysabri (natalizumab) is a newer intravenous treatment given once every 28 days. It is generally recommended as a second line agent for patients with definite RR MS who have failed therapy with the other four approved agents mentioned above. Generally speaking, all of these agents reduce the frequency and severity of relapses. They all reduce the number of lesions that may form and be seen on MRI of the brain over time. They all slow the progression of the disease. The choice between Avonex, Betaseron, Rebif, Copaxone, and Tysabri is complex and you should consult an MS expert or your neurologist. Treatment of Secondary Progressive MS Novantrone (mitoxantrone) is an IV medication used to treat secondary progressive MS. Some MS experts may also try one of the interferon preparations listed above under “Immunomodulatory Therapy.” In addition, other medications and combinations of medications are used by MS specialists. Contact an MS specialist or your neurologist for more information. Symptomatic Treatment of MS There are many treatments for MS symptoms that do not resolve after a relapse or progression. Please consult an MS expert or your neurologist for more information. |
