Relapsing-remitting MS is thought to be primarily an inflammatory disease of myelin in the CNS. The disease process is characterized by periodic relapses followed by complete or incomplete recovery. Simultaneously, however, irreversible axonal damage and transection are known to occur (Trapp et al., 1998). Controlling inflammation early in the disease may also reduce the damage to axons (Coyle, 2008). The medications that are currently available to treat MS appear to be most effective during the early, inflammatory phase of MS, becoming less potent as the disease transitions to a more neurodegenerative process.

Since 1993, ten medications have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of relapsing forms of MS (Jeffery, 2013). The information presented here is designed to allow a side-by-view of medication options without suggesting inter-medication comparisons, except where specifically supported by the results of head-to-head clinical trials. Comparing the efficacy of medications across trials is misleading because of key differences in the populations, outcome measures, and statistical analyses used in the studies.

Eight "First-line" FDA-approved disease-modifying therapies

Eight medications are FDA-approved for first-line use in relapsing forms of MS. Of these, five are delivered by injection and three are oral.

• Injectable options
  • Interferon b-1b (Betaseron; 1993)
  • Interferon b-1b (Extavia; 2009)
  • Interferon b-1a (Avonex; 1996)
  • Interferon b-1a (Rebif; 1998)
  • Glatiramer acetate (Copaxone; 1996) 

• Oral options
  • Fingolimod (Gilenya; 2010)
  • Teriflunomide (Aubagio; 2012)
  • Dimethyl fumerate (Tecfidera, 2013)

Additional FDA-approved disease-modifying therapies

Two additional medications – both delivered by intravenous infusion – are approved for the treatment of MS

• Natalizumab (Tysabri; 2006)
• Mitoxantrone (Novantrone; 2000)

Optimizing outcomes

FDA-Approved Disease-Modifying Therapies (DMTs) – a side-by-side view

• Indications, Dosing, Route of Administration, and Pregnancy Rating
• Warnings and Safety Management Strategies
• Common Side Effects
• Patient Support Programs

Emerging Therapies Collaborative

The Society has joined with other MS organizations to provide authoritative, evidence-based resources for clinicians and patients regarding the benefits and risks of newly-emerging FDA-approved medications.

Drug development pipeline

Read about compounds currently under investigation for therapeutic use in MS.