For most people, it’s better to take drugs for multiple sclerosis (MS) early rather than let the disease run its course, according to new treatment guidelines from the American Academy of Neurology.
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MS is a chronic inflammatory condition that affects the central nervous system. It can cause symptoms such as muscle weakness, vision problems and emotional problems, as well as difficulties with coordination and thinking. MS affects about 400,000 Americans and is a leading cause of disability among young adults.
Early is better than later
The previous guidelines were issued in 2002. One new development since then is recent research showing that using an MS drug as early as possible may be better than letting the disease run its course, says Alexander Rae-Grant, MD, lead author of the guidelines and a neurologist at Cleveland Clinic.. This is because the disease usually gets worse over time.
Damage to the central nervous system as a result of MS cannot be undone. But newer research shows that people may be able to slow the progression of their disease by taking MS medications sooner rather than later, Dr. Rae-Grant says.
Also since 2002, important new medicines have emerged, Dr. Rae-Grant says.
These disease-modifying drugs can alter or change the course of MS for patients, unlike treatments that simply manage symptoms. While these drugs are not a cure, they can reduce the number of relapses a person has and slow the progression of the disease.
“The previous guideline we had was in 2002, and at that time we only had a small array of medications for people with MS,” Dr. Rae-Grant says. “We now have 17 FDA approved medicines and it’s much more complicated, but much more exciting, in terms of what we can do for people with MS.”
If it doesn’t work, change it
Another new aspect of the guidelines advises switching to another drug when a person already taking medicines for MS experiences a return of disease.
“Our new guidelines push physicians to treat people earlier and to monitor them more carefully for change in their condition so that we can change medicines as they need them,” Dr. Rae-Grant says. “We know that we can’t take away any injury that’s occurred in the time during the disease, so the more we can be preventing things up front, the better we can do.”
Dr. Rae-Grant said it’s important for anyone with MS to talk to their doctor about the risks and benefits of MS medications before starting a treatment plan.
“The treatment landscape for people with MS has changed dramatically over the last decade,” he says. “We now have a number of disease-modifying therapies to choose from that may help treat MS by changing how the disease affects people over time by slowing the disease process.”
The new guidelines appear online in Neurology, the medical journal of the American Academy of Neurology.