Choosing the Best Multiple Sclerosis Drug For You

Essential Information About the Most Effective Treatment Options

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If you've been diagnosed with multiple sclerosis (MS), the right treatment can make a huge difference in your overall health and quality of life. Medications for treating MS, known collectively as disease-modifying drugs, are true to their name—they change the actual course of MS by reducing the number and frequency of new lesions in the brain and on the spine, especially ones that cause relapses.

They're a great improvement over the previous approach to treating MS —usually a combination of corticosteroids to shorten relapses, medications to address different symptoms, and physical and occupational therapy.

Each of the disease-modifying medications for MS does essentially the same thing but there are important differences to factor in as you and your doctor decide which is the best treatment option for you. Among other things you'll want to consider the type of MS you have, how easy the drug is to use, potential side effects, and how closely you may need to be monitored. 

Avonex (interferon beta-1a)

Interferon is a component of a protein naturally produced by the body. Avonex is made from this protein and has the exact same amino acids. It works by reducing the immune response that can attack nerve cells in your body.

  • Which type of MS does it treat? Relapsing-remitting MS; sometimes it's given to people who are suspected of having MS but haven't been diagnosed yet.  
  • How effective is it? Avonex has been shown to lower the relapse rate by 30 percent.
  • How is it given? Once a week by intramuscular injection, usually at home.
  • What are the possible side effects? Flu-like symptoms during the first few weeks—sometimes longer. Less common side effects are depression and liver dysfunction.
  • Precautions: Women who are pregnant or trying to conceive shouldn't take Avonex. It's not a good choice for people diagnosed with depression, anxiety, or who have trouble sleeping either. It's also not good for folks with thyroid  problems, anemia, easy bruising, or a history of seizures, heart problems, or liver disease. 

Betaseron (interferon beta-1b) 

Betaseron is made from another type of naturally-occurring interferon. Like Avonex, it works by diluting the immune response that can attack nerve cells in your body.

  • Which types of MS does it treat? Relapsing-remitting and progressive-relapsing.
  • How effective is it? Betaseron can lower the relapse rate by 30 percent.
  • How is it taken? Subcutaneous (under the skin) Sinjection every other day, usually done at home.
  • What are the possible side effects? During the first few weeks, maybe a bit longer, you may have flu-like symptoms. You also might have a reaction at the injection site, like swelling, redness, and pain. You can get around this by rotating among several different injection sites. Some people taking Betaseron suffer from depression.
  • Precautions: Betaseron isn't safe during pregnancy, so if you're a sexually active woman you should use a reliable form of birth control while you're taking it. You may need to have regular blood tests to monitor liver, thyroid, and blood counts.  

    Copaxone (glatiramer acetate)

    Copaxone (glatiramer acetate) is made from certain amino acids found in myelin thought to help switch the immune system from causing inflammation around lesions to actually reducing it. 

    • Which type of MS does it treat? Relapsing-remitting.
    • How effective is it? It reduces the relapse rate by 30 percent.
    • How is it taken? Subcutaneous (under the skin) injection every day, at home. 
    • What are the possible side effects? Injection site reactions may occur, including swelling, redness, and pain. Injection sites must be rotated.
    • Precautions: Like most other medications of its type, Copaxone isn't safe during pregnancy.

      Novantrone (mitoxantrone)

      This MS treatment is an antineoplastic, a type of medication first used to treat cancer. Novantrone works in MS by suppressing elements in the immune system that may attack myelin.

      • Which type of MS does it treat? Secondary-progressive, progressive-relapsing, and some types of relapsing-remitting.
      • How effective is it? In a two-year study in which Novantrone was compared to a placebo, the drug reduced the number of relapses and lengthened the amount of time between them. The people in the study who were taking Novantrone also had a 61 percent reduction in the deterioration of the ability to walk and significantly less neurological disability.
      • How is it taken? You'll need to go to your doctor's office or another treatment site every three months to receive an infusion of Novantrone intravenously. 
      • What are the possible side effects? Nausea, hair loss, menstrual disorders. If fever, chills, pain or other symptoms occur, you should tell your doctor.
      • Precautions:  Over time Novantrone can cause heart damage, so there's a limit to how long a person can be treated with it— no more than eight to 12 doses during the course two to three years. It also lessens the body's immune response, you don't get any sort of vaccination without getting the green light from your doctor first. Novantrone isn't safe for women who are pregnant or nursing a baby.

      Rebif (interferon beta-1a) 

      Rebif is a third type interferon-based medication for treating MS. 

      • Which type of MS does it treat? Relapsing-remitting.
      • How effective is it? It reduces the relapse rate by 30 percent.
      • How is it Taken? Subcutaneous (under the skin) injection three times a week. Usually done at home.
      • What are the possible side effects? Flu-like symptoms during the initial weeks. 
      • Precautions: Rebif isn't a good treatment choice for you if you're pregnant or nursing. You may have to have periodic blood tests to make sure the medication hasn't affected liver function, blood counts, or thyroid function.

      Tysabri (natalizumab)

      Tysabri is a monoclonal antibody that makes it more difficult for the cells of the immune system to move into the brain and spinal cord.

      • Which type of MS does it treat? Relapsing-remitting multiple sclerosis that hasn't responded to other treatments.
      • How effective is it? It lowers the MS relapse rate by 60 percent.
      • How is it Taken? Intravenously once every four weeks at a doctor’s office or another treatment site.
      • What are the possible side effects? Tysabri can cause headaches, pain, fatigue, depression, and diarrhea. Some people have allergic reactions to the medication. 
      • Precautions: Tysabri increases the risk of a viral infection of the brain called progressive multifocal leukoencephalopathy (PML) which can lead to severe disability or death. Because of this, a complex monitoring system is set up for people taking Tysabri. It's not a safe treatment for people with a weak immune system or women who are pregnant or breastfeeding.

      Source:

      National Institute of Neurological Disorders and Stroke. "Multiple Sclerosis: Hope Through Research."

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