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 much progress has been made 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 and to minimize the neurological damage they cause. The 13 DMTs approved by the Food and Drug Administration (FDA) since the early 1990s are effective at helping to manage relapsing-remitting MS, which affects 85 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 treatment during the earlier relapsing phase is recommended.
In addition, 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
No currently available DMTs significantly slow the worsening of the primary progressive form of MS. But early studies suggest the experimental drug ocrelizumab may be effective at slowing its progression.
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.
Clinical trials of new DMTs, including the monoclonal antibodies daclizumab (Zenapax) and rituximab (Rituxan) as well as laquinimod, an oral medication, are underway and may offer new benefits compared with currently available options.
Stem cell transplantation is also being evaluated as a treatment for MS. Several studies 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
More research is needed to better understand 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 only become clear with more research.
Dean M. Wingerchuk, M.D.
Jan. 12, 2016
- Wingerchuk DM, et al. Multiple sclerosis: Current and emerging disease-modifying therapies and treatment strategies. Mayo Clinic Proceedings. 2014;89:225.
- Freedman MS. Present and emerging therapies for multiple sclerosis. Continuum: Lifelong Learning in Neurology. 2013;19:968.
- Multiple sclerosis: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/multiple_sclerosis/multiple_sclerosis.htm. Accessed Dec. 21, 2015.
- Disease modification. National Multiple Sclerosis Society. http://www.nationalmssociety.org/For-Professionals/Clinical-Care/Managing-MS/Disease-Modification. Accessed Dec. 21, 2015.
- Wingerchuk DM (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. Dec. 23, 2015.
- Olek MJ. Clinical course and classification of multiple sclerosis. http://www.uptodate.com/home. Accessed Dec. 21, 2015.
- The MS disease-modifying medications. Multiple Sclerosis Association of America. http://www.nationalmssociety.org/Treating-MS. Accessed Nov. 11, 2015.
- Olek MJ. Treatment of progressive multiple sclerosis in adults. http://www.uptodate.com/home. Accessed Dec. 22, 2015.
- Olek MJ. Treatment of relapse-remitting multiple sclerosis in adults. http://www.uptodate.com/home. Accessed Dec. 22, 2015.
- More results released from positive Phase III clinical trial of ocrelizumab in primary progressive MS. National Multiple Sclerosis Society. http://www.nationalmssociety.org/About-the-Society/News/Positive-Results-Announced-from-Phase-III-Clinical. Accessed Dec. 23, 2015.