There is no cure for multiple sclerosis (MS) yet, but a number of treatment options, particularly for the relapsing-remitting form of the disease, have been approved to help manage symptoms and slow progression. These approved treatments include disease-modifying therapies that can modify or slow MS progression, medications to manage relapses, and therapies that address certain MS symptoms.
Learn more about some of the approved treatments used to treat MS and manage symptoms and relapses below.
Disease-modifying therapies, or DMTs, are a type of treatment that can alter the course of MS. Most of these therapies seek to suppress or modulate the immune system and reduce inflammation, slowing disease progression and helping prevent relapses.
DMTs approved by the U.S. Food and Drug Administration (FDA) have been proven to reduce the frequency and severity of MS relapses. Some also can have a preventive effect, lessening the development of new lesions (regions of damage) in the central nervous system and/or slowing the progression of disability.
Interferon-based treatments are a type of DMT used to treat relapsing MS. While the mechanisms through which interferon therapies work in MS are not completely understood, they are thought to alter immune activity in a manner that reduces the autoimmune attack on the nervous system. Some commonly used interferon medications for MS are listed below.
Avonex (interferon beta-1a) is an injectable medication approved for patients with relapsing forms of MS. Administered by injection into the muscle, it is designed to help reduce the number of flare-ups and brain lesions and delay disability progression.
Betaseron (interferon beta-1b) is an anti-inflammatory therapy indicated for patients with relapsing-remitting MS, active secondary progressive MS, and clinically isolated syndrome. Administered via subcutaneous injection, it is similar to other interferon beta formulations in that it reduces inflammation in the nervous system.
Extavia (interferon beta-1b) is a subcutaneous therapy intended to reduce the number of exacerbations and prevent the development of new brain lesions in patients with relapsing forms of MS.
Plegridy (peginterferon beta-1a) is approved to treat relapsing forms of MS. It is a “pegylated” form of interferon beta-1a that allows for less frequent dosing. It is an injectable formulation, administered under the skin once every two weeks.
Rebif (interferon beta-1a) is an under-the-skin injection therapy indicated for relapsing forms of MS. It is designed to reduce the frequency of disease exacerbations, delay the accumulation of physical disability, and prevent the development of new lesions.
Sphingosine-1-phosphate (S1P) receptor modulators are a class of oral DMTs that work by preventing immune cells from leaving the lymph nodes, entering circulation, and reaching the brain and spinal cord, where they can promote further inflammation and nerve cell damage.
Gilenya (fingolimod) is an oral disease-modifying therapy indicated for patients with relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS. It works by modulating the immune response to reduce disease exacerbations, delay the accumulation of disability, and prevent new lesions from forming.
Mayzent (siponimod) is an oral treatment used to treat relapsing forms of MS. It works by binding to the sphingosine-1-phosphate (S1P) receptors on the outside of immune cells, blocking their normal action. Mayzent keeps the immune cells trapped in the lymph nodes, slowing disease progression.
Ponvory (ponesimod) is a sphingosine-1-phosphate receptor 1 (S1P1) immunomodulator approved for the treatment of relapsing forms of MS. It is a once-daily oral therapy used to lower relapse rates and slow the development of brain lesions.
Zeposia (ozanimod) is a treatment developed to treat adults with relapsing forms of MS. It helps to reduce relapse rates and the development of new brain lesions.
The active ingredient in fumarate therapies, monomethyl fumarate (MMF), is generally believed to reduce MS-driving inflammation by changing the activity of immune cells. It also has antioxidant properties that may protect nerve cells against damage.
Bafiertam (monomethyl fumarate) is a disease-modifying therapy for relapsing forms of MS. While the exact mechanism of action of Bafiertam is not fully known, the medication’s active ingredient, monomethyl fumarate (MMF), is broadly thought to reduce the inflammation that drives MS.
Tecfidera (dimethyl fumarate) is an oral formulation approved for relapsing forms of MS. It is an immunomodulatory therapy that has been shown to reduce relapse rates, delay progression, and slow the development of brain lesions.
Vumerity (diroximel fumarate) is an oral treatment approved for people with relapsing forms of MS. It is available as delayed-release capsules. Vumerity is made of a small molecule called diroximel fumarate, which is an inactive prodrug that is converted into its active form, monomethyl fumarate, inside the body.
Anti-CD20 therapies target the CD20 protein on the surface of mature B-cells, the cells responsible for antibody production, leading to their death. These therapies have been shown to reduce relapse rates and the risk of disability progression.
Briumvi (ublituximab-xiiy) is an approved antibody-based therapy used to reduce relapses and slow the development of brain lesions in people with relapsing forms of (MS). This treatment is given intravenously via two infusions two weeks apart and then every six months therafter.
Kesimpta (ofatumumab) is approved to treat adults with relapsing forms of MS. It is the first MS therapy targeting B-cells that can be self-administered at home. The treatment is given once per month via under-the-skin injection using an autoinjector pen called the Sensoready Pen. It is also available in pre-filled syringes.
Ocrevus (ocrelizumab) is a humanized monoclonal antibody developed to treat MS. It is the first therapy approved in the U.S. to treat both relapsing forms of MS and primary progressive MS, the latter of which had no approved treatments previously.
Other disease-modifying therapies approved for MS work to dampen immune responses through a variety of mechanisms. These include oral and injectable therapies, and their dosing schedule ranges from once daily to one or two treatment courses per year.
Aubagio (teriflunomide) is an active metabolite of the compound leflunomide and is a pyrimidine synthesis inhibitor. It is an oral formulation that has immunomodulatory properties, which can mitigate the rate and extent of damage caused to nerve fibers in neurodegenerative conditions like MS.
Copaxone (glatiramer acetate injection) is a disease-modifying therapy approved for the treatment of relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS. Generic forms are also available.
Lemtrada (alemtuzumab) is an approved antibody-based therapy for relapsing forms of MS used to reduce relapses and prevent disability progression. Because Lemtrada can increase the risk of severe complications, it is generally recommended in the U.S. for patients who have failed to respond to at least two other MS treatments.
Mavenclad (cladribine) is a disease-modifying and short-course oral tablet treatment for people with active and relapsing forms of MS. The treatment is typically recommended for patients who failed to respond to, or were unable to tolerate, other MS therapies.
Mitoxantrone hydrochloride is an infusion medication used to slow disability progression and decrease the risk of relapses in people with relapsing forms of MS. It also is approved for nonactive SPMS. Originally sold under the brand name Novantrone, the therapy is available only as a generic medication.
Tysabri (natalizumab) is an antibody-based therapy approved to treat adults with relapsing forms of MS. It is available in the U.S. only through a restricted distribution program called TOUCH Prescribing Program because of its risk of progressive multifocal leukoencephalopathy.
For relapses, treatment broadly aims to dampen the acute inflammation that drives symptoms, thus speeding up recovery from relapses and reducing their severity. Glucocorticoids, a type of corticosteroids, are usually the first line of treatment for severe MS relapses. In patients who do not respond well or are unable to tolerate corticosteroids, therapies containing a purified form of the adrenocorticotropic hormone (ACTH) can be used as an alternative relapse management approach.
Glucocorticoids are hormones often used in the treatment of inflammatory and autoimmune disorders due to their powerful anti-inflammatory and immunosuppressive properties. In MS, they are useful for managing acute disease exacerbations or relapses — periods when symptoms suddenly get worse.
Dexamethasone is a man-made glucocorticoid with powerful anti-inflammatory and immunosuppressive properties that is often used in the treatment of inflammatory and autoimmune disorders such as MS. Dexamethasone works mainly by binding to glucocorticoid receptors in immune cells, prompting immune cells to take on a less inflammatory state.
Methylprednisolone is a man-made molecule that mimics cortisol and works mainly by dampening the inflammatory activity of immune cells. Like other corticosteroids, methylprednisolone works mainly by dampening the inflammatory activity of immune cells, decreasing their numbers and the pro-inflammatory signaling molecules they produce.
The man-made medication exerts its effects in MS mainly by binding to protein receptors on the surface of immune cells, thus dampening the inflammatory activity of these cells. Prednisone also reduces the permeability of blood vessels, which also limits the number of immune cells that reach the brain and cause damage.
These therapies contain a purified form of the adrenocorticotropic hormone (ACTH) that works by stimulating the production of cortisol and other hormones in the body.
Acthar Gel (repository corticotropin injection) is an injectable therapy used to manage acute relapses in MS. The treatment is usually considered for MS patients who have had inadequate responses, or cannot tolerate, corticosteroids.
Cortrophin Gel (repository corticotropin injection) is an injectable therapy approved to treat acute relapses. Cortrophin Gel’s mechanism of action is not fully known, but it is thought to work mainly by increasing cortisol levels, thus reducing the inflammatory autoimmune attack that drives MS exacerbations.
Many treatments may be used for managing MS symptoms. While these medications do not alter the course of the disease itself, they can ease individual symptoms to make them less bothersome and easier to cope with in day-to-day life.
Ampyra (dalfampridine) is an oral medication used to improve walking ability in people with MS. The treatment’s mechanism of action is not completely understood, but the medication is known to block the activity of potassium channels, thus improving the conduction of electrical signals in damaged neurons.
Botox (onabotulinumtoxinA) is an injectable treatment approved to ease spasticity in MS. The therapy also is approved for neurogenic detrusor overactivity in MS, when nerve damage causes the muscle around the bladder to be overactive. Although Botox can ease these symptoms of MS, it does not alter the progression of the disease.
Dysport (abobotulinumtoxinA) has been approved to treat upper and lower limb spasticity in adults (a common symptom of MS) and is currently being studied as a treatment for overactive bladder in MS patients. It is administered as an injection directly into the muscle.
The Portable Neuromodulation Stimulator, or PoNS, is an approved noninvasive medical device used in combination with physical rehabilitation to reduce MS-associated walking problems. The electrical signals delivered through the device are thought to create a natural flow of stimuli from the tongue to the brain, promoting neuroplasticity.
Visit the Multiple Sclerosis News Today forums to connect with others in the MS community. These forums are designed for patients, caregivers, and medical professionals to discuss issues, ask questions, and share experiences.
Get regular updates to your inbox.