Medications for MS provide some measure of control over the inflammation that injures nerve fibres, reduce the frequency and severity of relapses, and/or ease the impact of MS symptoms. Slowing the accumulation of nerve damage may also reduce or prevent further disability seen during the course of MS.
Those diagnosed with relapsing forms of MS have likely been advised to start treatment as soon as possible. The best course of action is to control the inflammation and prevent irreversible tissue damage early on. Current treatments available for relapsing forms of MS target the inflammatory process of MS; they have not been shown to be effective for the majority of people diagnosed with progressive disease, where inflammation plays a lesser role in the disease process.
Medications used to manage multiple sclerosis (MS) can be divided into several categories.
Disease-Modifying Therapies (DMT)
These are a class of drugs that impact the underlying disease. DMTs target some aspect of the inflammatory process of MS and appear to reduce the frequency and severity of relapses; reduce the number of new lesions in the brain and spinal cord as seen on MRI, and slow down the accumulation of disability. Decisions about taking a disease-modifying therapy are best made by carefully considering and weighing factors including individual lifestyle, disease course, known side-effects, and the potential risks and benefits of the different therapies.
Due to the large number of different MS therapies currently available, as well as the fact that each therapy may have a different mechanism of action, people with MS should discuss their disease management plans with their prescribing physician.
Health Canada has approved the following Disease-Modifying Therapies for people with relapsing forms of MS.
- Avonex (interferon beta-1a)
- Betaseron (interferon beta-1b)
- Copaxone (glatiramer acetate)
- Extavia (interferon beta-1b)
- Glatect (glatiramer acetate)
- Kesimpta (ofatumumab)
- Plegridy (peginterferon beta-1a)
- Rebif (interferon beta-1a)
- Aubagio (teriflunomide)
- Generic teriflunomide products
- Gilenya (fingolimod)
- Generic fingolimod products
- Mavenclad (cladribine)
- Mayzent (siponimod)
- Tecfidera (dimethyl fumarate)
- Generic dimethyl fumarate products
- Zeposia (ozanimod)
- Ponvory (ponesimod)
Symptom Management Therapies
These medications help ease MS-related symptoms such as fatigue, mobility impairment, spasticity, and pain, among others.
Relapse Management Therapies
These are steroid medications that help to decrease the severity and duration of MS relapses. A relapse – which can also be called an attack or exacerbation – is caused by inflammation in a specific area of the central nervous system. Steroids work to actively suppress the inflammation, which helps to improve relapse symptoms and speed healing.
Used over a short term, steroids are considered to be relatively safe by most practitioners. Side effects may include difficulty sleeping, stomach upset, and irritability. Over the long term these, drugs may impact other areas of the body, including liver and kidney function and bone density, among others, and so long-term and/or frequent use should be avoided.