I was recently diagnosed with multiple sclerosis. Are there any new treatments to help me fight this disease?

Answers from Dean M. Wingerchuk, M.D.

There is no cure for multiple sclerosis (MS), but there has been much progress in developing new drugs to treat it. Research is ongoing to develop new and better disease-modifying therapies (DMTs) for this disease of the central nervous system.

DMTs are designed to reduce the frequency and severity of MS attacks. DMTs also minimize the neurological damage these MS attacks cause. The majority of DMTs approved by the Food and Drug Administration (FDA) since the early 1990s are effective at helping to manage relapsing-remitting MS, which affects between 85 and 90 percent of people diagnosed with this disease.

After several years, most cases of relapsing-remitting MS convert to a gradually progressive form of the disease, known as secondary-progressive MS. Currently available DMTs have little impact on this phase of MS, so it's best to develop a treatment regimen during the earlier relapsing-remitting phase.

About 10 percent of people with multiple sclerosis are diagnosed with a progressive form (primary-progressive MS) at the onset of the disease.

New therapies are emerging

The recently FDA-approved drug ocrelizumab (Ocrevus) reduces relapse rate and risk of disability progression in relapsing-remitting MS. It's also the first DMT to slow the progression of the primary-progressive form of MS.

Another DMT, daclizumab (Zinbryta), was approved by the FDA in 2016 for relapsing-remitting multiple sclerosis. Daclizumab helps to reduce relapse rates. But the FDA cautioned that this drug should only be used in people in whom at least two other drugs were ineffective, due to possible side effects including infections and liver problems.

Researchers are learning more about how existing DMTs work to lessen relapses and reduce MS-related lesions in the brain. Further studies will determine whether these mechanisms can potentially delay disability caused by the disease.

Stem cell transplantation also is being evaluated as a treatment for MS. Researchers are exploring whether destroying the immune system and then replacing it with transplanted stem cells can "reset" the immune system in people with MS.

More research is needed

Further study can help better show how these new therapies work and how best to use them as part of a holistic treatment strategy. Although initial research shows promise, the benefits, side effects and long-term safety of these new drugs will become clear with more research.

With

Dean M. Wingerchuk, M.D.

Aug. 30, 2017 See more Expert Answers