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.
People 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 MS can be divided into several categories.
Disease-Modifying Therapies (DMT)
These medications 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.
Injectable Medications
- Avonex (interferon beta-1a)
- Betaseron (interferon beta-1b)
- Copaxone (glatiramer acetate)
- Glatect (glatiramer acetate)
- Glatiramer Acetate Injection (glatiramer acetate)
- Kesimpta (ofatumumab)
- Plegridy (peginterferon beta-1a)
- Rebif (interferon beta-1a)
Oral medications
- Generic teriflunomide products
- Gilenya (fingolimod)
- Generic fingolimod products
- Mavenclad (cladribine)
- Mayzent (siponimod)
- Tecfidera (dimethyl fumarate)
- Generic dimethyl fumarate products
- Zeposia (ozanimod)
- Ponvory (ponesimod)
Infused medications
Stem Cell Treatment
Autologous hematopoietic stem cell transplantation (aHSCT) is a one-time procedure and for some people it can significantly reduce and potentially stop MS disease activity.
Symptom Management Therapies
These medications help ease MS-related symptoms such as fatigue, mobility impairment, spasticity, and pain, among others.
Steroids
Steroids can lessen the severity and the length of an MS attack. They speed up recovery when a relapse is affecting your ability to function. Steroids come with side effects for some people. Over the short term, irritability, difficulty sleeping and stomach upset are common and can be managed with medication. Over the long term, steroids can cause problems with bone health, and eye health. For this reason, they’re used cautiously. Research suggests that while steroids are very helpful in managing a relapse, ultimately, outcomes are not affected.