Treatment, therapies and management

At present there is no cure for MS, but management of the disease includes various pharmacological strategies such as drug treatments to speed up the clinical improvement from relapses, medications that reduce the risk of further relapses (commonly known as disease modifying therapies) and therapies that alleviate and improve various symptoms. In addition to these drugs, successful management of MS also includes a healthy diet, exercise and rehabilitation. 

Acute relapses are commonly treated with steroids, which can be given intravenously or orally for only a few days. These are generally well tolerated and improve symptoms, but do not change the risk of future relapses.

Disease modifying drugs can instead reduce the frequency and severity of relapses. Whether any of these drugs slow down the rate of disability in the long term is not yet clear and is a current focus of research. Early stage clinical trials focus on safety of new compounds, while late stage trials focus on efficacy and identifying patient populations that may benefit most from particular treatments. Several new oral drugs are currently being tested in late stage clinical trials and one of them has become recently available. As more genomic data becomes available, individual targeting of therapies will become an exciting research area for the future.  

MS is associated with a range of symptoms making their management important but challenging. A multidisciplinary approach is vital to improving quality of life and management strategies can involve a combination of drug treatments and rehabilitation. While some symptoms such as bladder issues respond well to current medications, improving treatments in more difficult areas such as fatigue and cognition are research challenges for the future.

Complementary and alternative therapies are treatments that generally fall outside the realm of conventional medicines. Current areas of MS research focus on the efficacy of a diverse range of treatments from cannabis to vitamin supplements and yoga to acupuncture. Studies suggest that these therapies are used by a large proportion of people with MS and often used alongside conventional medication.

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