Disease-modifying therapies

The following information should not be relied on to suggest a course of treatment for a particular individual, and it should not be used in place of a visit, call, consultation or the advice of a physician or other qualified healthcare provider. 

Disease–modifying therapies (DMTs) are not a cure for MS but aim to prevent or reduce the number of relapses that occur, as well as slowing down the overall progression of the disease. So far, only a few drugs have been approved specifically to treat progressive MS. In some countries, people with relapsing forms of MS who are initially treated with one of the above drugs and are subsequently diagnosed with secondary progressive MS, can continue with their existing treatment if they still experience relapses (a phase described as active secondary progressive MS). In other countries, however, being diagnosed with secondary progressive MS can act as a trigger to stop the individual from being prescribed with drugs approved for relapsing MS. Depending on the type of MS you have and where you live in the world will determine which treatments are available to you. 

Injectable medications 

• beta interferon-1a (Avonex): injected into a muscle once a week. 

• beta interferon-1a (Rebif): injected under the skin three times a week. 

• beta interferon-1b (Betaferon): injected under the skin every other day. 

• beta interferon-1b (Extavia): injected under the skin every other day. 

• glatiramer acetate (Copaxone, Brabio): injected under the skin daily, or three times a week at a higher dose. 

• glatiramer acetate (generic): injected under the skin daily. 

• ofatumumab (Kesimpta): injected under the skin once every four weeks. 

• peginterferon beta 1a (Plegridy): injected under the skin once every two weeks. 

Oral medications 

• cladribine (Mavenclad): pills taken for up to five consecutive days in the first month and for up to five consecutive days in the second month, with the same course repeated a year later. This may need to be repeated at some point in the future. 

• dimethyl fumarate (Tecfidera): taken as a capsule, twice daily. 

• diroximel fumarate (Vumerity): taken as a capsule, twice daily. 

• monomethl fumarate (Bafiertam): taken as a capsule, twice daily. 

• fingolimod (Gilenya): taken as a capsule, once daily. The first dose is taken under medical supervision to monitor heart rate and blood pressure. 

• siponimod (Mayzent): approved to treat relapsing forms of MS and clinically isolated syndrome. It is taken as a tablet, once a day. 

• ozanimod (Zeposia): taken as a tablet, once daily. 

• ponesimod (Ponvory): taken as a tablet, once daily. 
• teriflunomide (Aubagio): taken as a tablet, once daily. 

Infusion medications 

• alemtuzumab (Lemtrada): taken as two treatment courses of intravenous infusions (IV or ‘drip’). The first course consists of intravenous infusions on five consecutive days. The second course is taken 12 months later and consists of intravenous infusions on three consecutive days. Some people may need a third or further infusion. 

• ocrelizumab (Ocrevus): taken as an intravenous infusion, with a more intense course to start and then further infusions every six months. 

• natalizumab (Tysabri, Tyruko): taken as an intravenous infusion once every four weeks. 

• ublituximab (Briumvi): taken as an intravenous infusion every six months following a starting dose. 

Other drugs that have been used to modify the disease course in MS 

In some countries, a number of other immune suppressing or modifying treatments are used to treat MS, although in many countries these have been replaced by the treatments above.  

‘Off-label’ treatments are those that have been approved for other conditions, but not specifically MS. Off-label DMTs are often more readily available and affordable in health systems and may provide a treatment option where other DMTs are unavailable or unaffordable. 

Neurologists and people with MS need to work together to balance the positive effects of the drugs against their potential adverse side effects. These drugs include: 

• azathioprine (Imuran) 

• cladribine (IV version) 

• cyclophosphamide (Endoxana) 

• fludarabine (Fludara) 

• intravenous immunoglobulin (IVIg) 

• leflunomide (Arava) 

• methotrexate (Maxtrex) 

• minocycline 

• mitoxantrone (Novantrone) 

• mycophenolate mofetil (CellCept) 

• rituximab (Rituxan, Mabthera, and other generics) 

You can read more about the use of off-label treatments for MS here: Off-label treatments for MS – MS International Federation 

Sharifah injecting herself at her home in Kuala Lumpur, Malaysia.

Oumaima Benaiche receiving her infusion treatment in hospital Fes, Morocco.