MS disease-modifying therapies (DMTs) are a crucial component of managing the condition, aiming to reduce the frequency and severity of relapses, slow disease progression, and minimise long-term disability. These treatments work by modulating or suppressing the immune system to prevent it from attacking the protective myelin sheath around nerve fibres.
With various options available – injectables, oral medications, and infusion – DMTs are tailored to individual patients based on factors like disease type, severity, and lifestyle considerations. While they do not cure MS, these therapies play a vital role in improving the quality of life and long-term outcomes for those living with the disease.
Multiple sclerosis (MS) is a chronic neurological condition that affects the central nervous system. While there is no cure, MS disease-modifying therapies (DMTs) play a crucial role in slowing disease progression, reducing relapses, and improving long-term outcomes. These therapies are vital in managing MS effectively, offering patients a better quality of life and hope for the future.
Having had MS for thirty years, I was offered Beta Interferon early in the course of my disease. At the time, my GP did not stress how severe the condition could become. Perhaps she had little experience in dealing with multiple sclerosis. The possible side-effects of Beta Interferon were constant flu-like symptoms. I was not prepared to take this risk, so I declined the treatment.
How Do Disease-Modifying Drugs for MS Work?
Disease-modifying drugs for MS help by altering immune system activity to reduce inflammation and damage to the nervous system. They do not reverse existing damage but are effective in slowing progression and preventing new lesions from forming. These therapies work through various mechanisms, including:
- Suppressing overactive immune responses
- Reducing the frequency of MS relapses
- Minimising nerve damage to slow disease progression
The Different Types of Disease-Modifying Treatments for MS
1. Injectable DMDs for MS
The first disease modifying treatments for MS introduced were injectable therapies, which remain an option for many patients. These include:
- Beta Interferons (Avonex, Rebif, Betaferon, Plegridy)
- Glatiramer Acetate (Copaxone)
These medications help regulate the immune system, reducing the attack on the central nervous system.
2. Oral MS Disease-Modifying Therapies
Oral DMTs provide convenience with effective results. Some commonly prescribed oral medications include:
- Aubagio (teriflunomide) – Helps reduce relapses by inhibiting immune cell activation.
- Gilenya (fingolimod) – Traps immune cells in lymph nodes, preventing them from attacking nerves.
- Mavenclad (cladribine) – A selective immune reconstitution therapy, used in highly active MS cases.
3. Infusion-Based Therapies
For those needing stronger treatment, infusion therapies provide powerful immune system modulation. These include:
- Ocrevus (ocrelizumab) – A B-cell depleting therapy suitable for relapsing and primary progressive MS.
- Tysabri (natalizumab) – Prevents immune cells from entering the brain and spinal cord.
- Lemtrada (alemtuzumab) – Affects immune cells over the long term to slow disease progression.
Symptomatic management in multiple sclerosis focuses on alleviating specific symptoms such as fatigue, spasticity, and pain to improve patients’ quality of life.
Administration Routes and Forms of MS Disease-Modifying Therapies
The administration route forms of MS treatments vary depending on the type of DMT. Some are taken orally, others require self-injection, while some need to be administered via infusion at a medical facility.
Choosing the Right Disease-Modifying Treatment for MS
Selecting a treatment depends on multiple factors, including disease severity, side effects, and lifestyle preferences. The route forms of MS approved treatments offer flexibility, enabling patients to choose the most suitable option.
Availability and Regulation of MS Disease-Modifying Therapies
In Australia, approved for by the TGA treatments are regulated for safety and efficacy. Many TGA available on PBS medications ensure affordability for eligible patients through government support.
Managing MS Symptoms Beyond Disease-Modifying Therapies
While DMTs are essential, multiple sclerosis treatment options include lifestyle changes, physical therapy, and symptom management strategies. Complementary therapies like physiotherapy, dietary adjustments, and stress management contribute to overall well-being.
Managing MS symptoms requires a combination of medication, lifestyle adjustments, and self-care strategies to maintain overall well-being.
Best Medications for MS Flare-Ups
In addition to DMTs, corticosteroids such as methylprednisolone help in managing acute relapses. Best medications for MS flare-ups focus on reducing inflammation and hastening recovery from attacks.
Addressing Other Health Concerns in MS Patients
Some individuals with MS experience additional health conditions. For example, Gastroparesis causes digestive issues due to nerve damage affecting stomach muscles. Managing related symptoms ensures better quality of life.
Frequently Asked Questions
Disease-modifying therapies for MS include injectable, oral, and infusion-based treatments. Common examples are Beta Interferons, Gilenya, Tysabri, Ocrevus, and Mavenclad. These treatments reduce relapses and slow disease progression.
Disease-Modifying Therapies (DMTs) – Slow disease progression and reduce relapses.
Symptom Management Medications – Treat issues like muscle spasms, fatigue, and pain.
Lifestyle and Rehabilitation Therapies – Include physiotherapy, diet modifications, and mental health support.
Avoid smoking – It can accelerate disease progression.
Don’t neglect exercise – Regular movement helps maintain muscle strength and flexibility.
Avoid extreme heat – High temperatures can worsen MS symptoms.
Don’t ignore mental health – Anxiety and depression are common in MS and should be managed.
Clinically Isolated Syndrome (CIS) – A first episode of neurological symptoms suggestive of MS.
Relapsing-Remitting MS (RRMS) – Characterised by flare-ups followed by partial or complete recovery.
Secondary Progressive MS (SPMS) – Follows RRMS, leading to a gradual worsening over time.
Primary Progressive MS (PPMS) – Progressive worsening of symptoms from the onset without relapses.
Conclusion
MS disease-modifying therapies have transformed treatment, providing hope and improved outcomes for patients. With options ranging from injectables to oral medications and infusions, individuals can tailor their treatment to best suit their needs. While DMTs help control disease activity, a holistic approach involving lifestyle modifications and symptom management ensures the best quality of life for those living with MS.
