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Multiple Sclerosis Treatment Options

While there is no known cure for multiple sclerosis (MS), doctors of the Multiple Sclerosis Program are well-versed in the latest disease-modifying therapies to slow progression and reduce relapses. By working closely with each patient, neurologists can incorporate the following treatments into individualized treatment plans.

  • Infusions — Delivered intravenously, four different infused medications are available to treat MS.
    • Alemtuzumab binds to and kills the white blood cells responsible for attacking the myelin sheath. It is delivered through five consecutive days of infusions and then, one year later, three consecutive days of infusions. Alemtuzumab may be readministered after the first two doses based on new disease activity. This medication is recommended for patients who have not responded to at least two other disease-modifying therapies.
    • Mitoxantrone is also designed to reduce the amount of damaging cells. It may typically be administered once every one to three months for about two to three years. However, because mitoxantrone may damage the heart and cause congestive heart failure during or following therapy, this option is reserved for more severe cases of MS.
    • Ocrelizumab is the first disease-modifying therapy for patients with a progressive form of MS known as primary progressive MS. It is designed to bind to and reduce the number of damaging B cells in the body. The first full dose is given as two separate infusions, two weeks apart. The next doses are given as one infusion every six months.
    • Natalizuman is a synthetic monoclonal antibody intended to discourage CNS-damaging cells from crossing the blood-brain barrier into the CNS. It is given once every four weeks.
  • Injectable medications — These may include injections of interferons, or naturally occurring proteins that may help regulate the immune response, into a muscle or under the skin. Injectable medications may also include glatiramer acetate, a synthetic protein, which is designed to stimulate the proteins that create/protect the myelin sheath and block T-cells that may damage the myelin.
  • Oral medications — Three different oral medications have been approved by the U.S. Food and Drug Administration to modify the course of MS. These are:
    • Dimethyl fumarate
    • Fingolimod
    • Teriflunomide
  • Steroid therapy — While disease-modifying therapies are the best option to manage disease progression, steroid therapy is one of the most effective solutions during an MS episode that is caused by new disease activity or flare-ups brought on by the inflammation of existing lesions. In the event of an MS episode, a neurologist may intravenously administer a steroid called Solu-Medrol, followed by a taper of an oral steroid known as prednisone. Steroids are not intended to be used for long periods of time.