An exciting era of treatments for relapsing-remitting multiple sclerosis

Abstract

‘Sustained disease-activity-free’ is now the overarching goal of treatment for multiple sclerosis (MS). Relapsing–remitting MS (RRMS) is still not curable, but it is increasingly regarded as treatable if targeted with disease-modifying therapies early on. It is an exciting time in the MS treatment arena, with a range of licensed drugs available and others poised to enter the market soon. Treatment with injectable products such as beta interferon and glatiramer acetate has been increasingly common since the 1990s; these products have proven efficacy in reducing relapses, conservative side effects and a good risk-to-benefit ratio. In 2006, natalizumab, a targeted monoclonal antibody that is highly efficacious but can be associated with severe adverse events, was licensed as a monotherapy for rapidly evolving severe RRMS. Novel oral drugs with proven efficacy are also emerging. The first of these—fingolimod (Gilenya)—was launched in 2013 and is now used by more than 78 000 people worldwide, and 1500 in the UK. Other oral therapies are under investigation. Although oral therapies offer the potential for increased patient tolerability and convenience, their varying efficacy and tolerability as well as potentially serious side effects need to be considered and monitored to ensure patient safety. The MS nursing role continues to be necessary to ensure that patients are educated regarding realistic treatment expectations and are closely supported and monitored.