I was recently diagnosed with multiple sclerosis. Are there any new treatments to help me fight this disease?
Answer From Iris Marin Collazo, M.D.
There is no cure for multiple sclerosis (MS). However, progress has been made in developing new medicines to treat it. Research is ongoing to develop new and better disease-modifying therapies (DMTs) for this disease of the central nervous system.
DMTs can reduce the frequency and severity of MS attacks. DMTs also can slow the progression of disability and the loss of brain volume mass. The majority of DMTs approved by the U.S. Food and Drug Administration (FDA) are effective at helping to manage relapsing-remitting MS. This form of MS affects between 85% and 90% of people diagnosed with this disease.
Some people with relapsing-remitting MS may transition to secondary-progressive MS after several years. Currently available DMTs have little impact on this phase of MS. So it's best to develop a treatment plan during the earlier relapsing-remitting phase.
About 10% to 15% of people with multiple sclerosis are diagnosed with a progressive form, called primary-progressive MS (PPMS), at the onset of the disease. A DMT called ocrelizumab (Ocrevus) can slow down the progression of disability over time.
New therapies are emerging
Ublituximab-xiiy (Briumvi) was approved by the FDA in 2022. It is used to treat relapsing-remitting and active secondary-progressive forms of MS. Ublituximab-xiiy is given in a vein and stops certain immune system cells from making antibodies that may damage the brain and spinal cord in MS.
Ofatumumab (Kesimpta) was approved by the FDA in 2020. This medicine is a self-injection treatment used for relapsing-remitting and secondary-progressive forms of MS. Ofatumumab is a medicine that destroys certain immune system cells that damage the body in MS. It helps reduce both relapses and progression of disability.
Siponimod (Mayzent) was approved by the FDA in 2019. This tablet is taken orally and is approved for relapsing-remitting and secondary-progressive forms of MS. Siponimod is a medicine that stops certain cells that can cause damage in MS from entering the central nervous system. It also helps reduce both relapses and progression of disability.
Cladribine (Mavenclad) is another oral tablet approved by the FDA in 2019. It is used to treat relapsing-remitting and secondary-progressive forms of MS. In clinical trials, cladribine reduced the progression of disability and significantly reduced relapse rates. Because of safety risks, cladribine is generally used when people can't take other medicines for MS or when those medicines aren't effective.
Researchers are learning more about how existing DMTs work to lessen relapses and reduce MS-related lesions in the brain. Further studies may show whether these treatments might delay disability caused by the disease.
Research on stem cell transplantation as a therapy for MS is ongoing. Researchers are exploring whether destroying the immune system and then replacing it with transplanted stem cells can "reset" the immune system of someone with MS.
More research is needed
Further study can offer more information about how well these therapies work and how they might be used more effectively. Although initial research shows promise, the benefits, side effects and long-term safety of these new medicines need more research.
With
Iris Marin Collazo, M.D.
July 03, 2024
- Wingerchuk DM, et al. Multiple sclerosis: Current and emerging disease-modifying therapies and treatment strategies. Mayo Clinic Proceedings. 2014; doi:10.1016/j.mayocp.2013.11.002.
- Olek MJ, et al. Initial disease-modifying treatment of relapsing-remitting multiple sclerosis in adults. https://www.uptodate.com/contents/search. Accessed April 24, 2024.
- Multiple sclerosis. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/multiple-sclerosis. Accessed April 24, 2024.
- Disease modification. National Multiple Sclerosis Society. https://www.nationalmssociety.org/for-professionals/for-healthcare-professionals/managing-and-treating-ms/disease-modification. Accessed April 24, 2024.
- FDA approves new oral treatment for multiple sclerosis. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-new-oral-treatment-multiple-sclerosis. Accessed April 24, 2024.
- Olek MJ, et al. Clinical presentation, course, and prognosis of multiple sclerosis in adults. https://www.uptodate.com/contents/search. Accessed April 24, 2024.
- Disease-modifying therapies. National Multiple Sclerosis Society. https://www.nationalmssociety.org/managing-ms/treating-ms/disease-modifying-therapies. Accessed April 24, 2024.
- Wingerchuk DM, et al. Disease modifying therapies for relapsing multiple sclerosis. The BMJ. 2016; doi:10.1136/bmj.i3518.
- FDA approves new drug to treat multiple sclerosis. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-new-oral-drug-treat-multiple-sclerosis. Accessed April 24, 2024.
- Olek MJ, et al. Overview of disease-modifying therapies for multiple sclerosis. https://www.uptodate.com/contents/search. Accessed April 26, 2024.