The disease multiple sclerosis is not yet curable, so the therapy mainly treats the symptoms. The goal of therapy is to relieve the symptoms of those affected. This includes making signs of a relapse disappear, slowing the progression of the disease, and preventing complications and long-term limitations.
Multiple sclerosis therapy is based on two pillars: First, relapse therapy to treat an acute relapse, and second, progression-modifying therapy to reduce the number and severity of relapses.
Medications for MS
Accordingly, when and why which agents and medications can help MS varies:
- Progression-modifying therapy medications are given preventively to lessen the frequency and severity of multiple sclerosis relapses. With such long-term therapy, the immune response is suppressed, and with it the autoimmune response that underlies MS. So-called immunomodulators (interferon, glatiramine acetate), which are injected into the muscle or under the skin, are used for this purpose. If the multiple sclerosis progresses, the next step is to administer low-dose cytostatics or immunoglobulins via the vein, which also curb the immune reactions. In a highly active form of progression or if the other immunotherapeutics do not work, fingolimod, siponimod, alemtuzumab or natalizumab can be given. Also new is the therapy option with Ozanimod, which is currently in the approval process.
- In acute relapse, glucocorticoids such as cortisone are given as an infusion for relapse therapy. In more severe cases, additional blood washing (plasmapheresis) are used.
- Nonspecific complaints such as pain, increased muscle tension (spasticity), emptying disorders of the bladder or bowel and depression are treated symptomatically with appropriate agents.
Supportive measures in the therapy of MS
Therapy for MS also includes supportive measures such as physiotherapy and occupational therapy to maintain mobility as long as possible and avoid complications such as kidney or lung infections. Psychotherapy can also help patients to cope better with life with MS. Cannabinoids or botulimuntoxin can also be used to combat spasticity.
Alternative treatments such as certain diets, acupuncture, homeopathy, meditation, relaxation techniques, or craniosacral therapy may be used to accompany MS therapy; however, scientific evidence of effectiveness is largely lacking.
Read more about nutrition, exercise, and working with multiple sclerosis here.
