Multiple Sclerosis Treatment and Management

​There is no cure yet for multiple sclerosis. Treatments for MS focus on managing symptoms, reducing the frequency, severity and duration of attacks, and attempting to slow disease progression.

Treatment for Attacks and Symptoms

If you are experiencing attacks severe enough to interfere with your ability to function, you may benefit from several treatment options, such as:

  • Corticosteroids, usually in high doses to reduce nerve inflammation
  • Plasmapheresis (plasma exchange) – a procedure in which the liquid portion (plasma) of the blood is removed and replaced with a substitution. In individuals with MS, plasmapheresis removes proteins in the blood partially responsible for attacking the central nervous system

Multiple sclerosis causes a variety of symptoms that include changes to sensation, muscle function, cognitive ability and emotion.

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Physical and cognitive treatments used to help manage symptoms include:

Rehabilitation therapy and counseling services

Medications

Complementary therapy

Treatment for Multiple Sclerosis

Numerous medical therapies are available to reduce disease activity and residual disability. Specific treatment for multiple sclerosis is determined by several factors, including where you are in the disease course, your medical history and care preferences.

MS is typically defined by the following courses:

  • Relapsing-remitting MS (RRMS): the most common disease course characterized by clearly defined attacks of damaging neurologic function. These attacks (also called exacerbations or flare-ups) are followed by periods of limited or full recovery (known as remissions) without continuous worsening between attacks. Relapsing remitting disease is further characterized as active or stable based on the presence of recent relapses or MRI measured disease activity.

Progressive forms of MS

  • Secondary-progressive (SPMS): follows years of a relapsing remitting course or can occur after a single relapse; this is further classified by the degree of inflammatory activity and rate of continuous worsening.
  • Primary-progressive MS (PPMS): characterized by continuous worsening of neurologic function from the onset of the disease. Further classified by presence or absence of inflammatory activity.

​Our specialists assess your individual condition to identify whether you are likely to benefit from a selected therapy.

Medical therapies we offer include:

  • Injectable therapies: These treatments include beta interferons (interferon beta- 1a and interferon beta- 1b) and glatiramer acetate, which are immune-modulating medications designed to reduce the frequency and severity of relapses.
  • Oral therapies: Available as second line treatment and in some cases first line treatment for relapsing forms of MS. These medications include Fingolimod, Dimethyl Fumarate and Teriflunomide.
  • Monoclonal antibody treatment: A monoclonal antibody is a laboratory-produced molecule created to specifically bind to target cells or proteins. Monoclonal antibodies such as Natalizumab block potentially damaging immune cells from entering the brain and spinal cord. Rituximab reduces a specific type of lymphocyte called a CD20 B-cell that contributes to the damage of the myelin sheath. Alemtuzumab depletes all lymphocytes and tends to produce greater immune suppression.
  • Chemotherapy: Intended for especially severe forms of relapsing-remitting and secondary-progressive MS, chemotherapy drugs such as cyclophoshamide work by suppressing the immune system and reducing the amount of immune cells causing inflammation.

Because each medical therapy may cause side effects, the risks and benefits of each treatment must be thoroughly considered. Chemotherapy drugs are often only considered in certain individuals because of the potential short and long term risks associated with treatment.

As a chronic, progressive disease, multiple sclerosis eventually leads to increasing disability in most individuals. Currently, no known therapies have shown benefit for people who have progressive MS with no evidence of ongoing inflammatory activity.

Researchers are actively working to find effective treatments for this type of progressive MS.