Disease-modifying therapies (DMTs) are treatments that can reduce the activity and progression of multiple sclerosis (MS). They can be useful for both people with relapsing-remitting MS (RMS) and relapses of progressive forms of MS. A relapse is the worsening of symptoms and/or the appearance of new ones, which last at least 24 hours and are separated from a previous relapse by at least one month.
Disease-modifying therapies approved by the U.S. Food and Drug Administration (FDA) have been shown to reduce the frequency and severity of relapses.
DMTs can also reduce the development of new lesions in the brain and spinal cord as seen on MRI scans, and appear to slow the development of MS disabilities.
An early intervention with these treatments may help prevent permanent damage to the nervous system, which is associated with the destruction of myelin.
Unless the side effects are intolerable, the treatment is not controlling the disease adequately, or a more appropriate treatment becomes available, these treatments should be continued indefinitely.
No DMTs are approved for women who are pregnant or plan to become pregnant or who are breastfeeding.
- Avonex: Typically used as first-line treatment, Avonex is a weekly injection for relapsing forms of MS.
- Betaseron: Typically used as a first-line therapy, Betaseron is an injection taken every other day for relapsing forms of MS.
- Extavia: The generic equivalent for Betaseron.
- Plegridy: Typically used as first-line treatment, Plegridy is an injection taken every two weeks for relapsing forms of MS.
- Rebif: Typically used as first-line treatment, Rebif is taken three times a week for relapsing forms of MS.
- Copaxone: A daily (20 mg) or three times per week (40 mg) first-line injection for relapsing forms of MS.
- Glatopa: The generic equivalent for Copaxone.
- Zinbryta (daclizumab): A monthly injection second-line treatment for relapsing forms of MS. Due to potential for serious complications, Zinbryta has a special FDA monitoring plan.
- Aubagio (teriflunomide): A once-daily first-line treatment for relapsing forms of MS.
- Gilenya (fingolimod): A once-daily second-line treatment for relapsing forms of MS. Due to the potential for serious complications, Gilenya has a special FDA monitoring plan.
- Tecfidera (dimethyl fumarate): A twice-daily first-line treatment for relapsing forms of MS.
- Lemtrada (alemtuzumab): A second- or third-line treatment for relapsing forms of MS. It is used as an infusion for five consecutive days, then three days 12 months later. Due to the potential for serious complications, Lemtrada has a special FDA monitoring plan.
- Novantrone (mitoxantrone): A third-line infusion treatment for progressive or worsening MS, used every three months.
- Ocrevus (ocrelizumab): Twice-annual infusion treatment.
- Tysabri (natalizumab): Second-line infusion treatment for relapsing forms of MS with a four-week-interval. Due to potential for serious complications, it has a special FDA monitoring plan.
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