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What can be done?
Treating MS involves considering many factors. The patient, along with their healthcare team, should be at the centre of all decision-making. Friends and family can also play an important role throughout the treatment process. While the treatment goals and process may vary from person to person, it is crucial that – along with the proper lifestyle interventions – everyone treat MS symptoms early, monitor disease activity regularly, formally record responses to MS treatments, and switch treatments rapidly, if needed.
Check out the latest articles on current MS topics
Be Your Own
Best Advocate
People living with MS play an important role in making treatment decisions.
Things to consider for MS treatments
Effectiveness, side effects, and safety
MS is a complex and highly unpredictable disease that affects everyone differently.
- Disease-modifying therapies (DMTs) are medications that target the inflammatory process of MS. DMTs appear to reduce the frequency and severity of relapses; the number of new lesions in the brain and spinal cord as seen on MRI scans; and slow down the accumulation of disability.
- Each treatment option comes with its own safety and side-effect considerations. The benefits and risks of each treatment option should be discussed with a patient’s healthcare team.
Medical plans and insurance
Different people have different levels of medical coverage that may cover all or part of the costs associated with their MS treatment.
This can include:
- Private insurance
- Federal government insurance
- Provincial government insurance
Pregnancy
MS is typically diagnosed between the ages of 20-50, the family-building years. While women can experience relief from MS symptoms during pregnancy, approximately 20-40% will have a relapse a few months after giving birth.
If someone living with MS is planning to start a family, it is important that they seek information on how MS treatments could affect pregnancy.
Travelling
In normal circumstances, most people with MS can travel safely with some advanced research and planning. Be sure to check your local guidance for travel and talk to your doctor before travelling. Your doctor can help you determine whether it is possible to travel safely with your medications and what preparations you might need to make.
Here are some things to keep in mind:
- If travelling with injectable medications within Canada, keep all medications in their original packaging, showing the prescription label, and request a letter from your doctor describing the medications and medical devices you need.
- Requirements for the U.S. are a lot stricter and so all medications must be in their original packaging and have professional, pharmaceutical pre-printed labels clearly identifying the medication.
- It is important to let the airline know what assistive devices you use, at the time of booking and whether you will need help on the plane.
Staying active is beneficial and travelling is a good way to get out and get moving. According to health experts, the biggest threat while travelling is a flare-up of an already existing medical condition. So, before travelling:
- Make sure to see your doctor in order get all documentation, prescriptions and medical care you need, as well as any necessary vaccinations.
- Ensure you have enough medication to last you the length of the vacation plus one extra week.
- Wear a MedicAlert ID to alert first responders and other health care professionals about your condition and the medications you take.
Types, forms, and frequency of medication
When evaluating treatment options, there are choices between different types or forms of medication and different dosing schedules.
Adverse events vary by treatment, and each potential treatment should be discussed with your doctor in depth.
TYPES OF MEDICATIONS
Currently, there are a number of MS medication
types authorized for sale by Health Canada.
INJECTION
AVONEX™ (interferon beta-1a)
BETASERON® (interferon beta-1b)
COPAXONE® (glatiramer acetate)
EXTAVIA® (interferon beta-1b)
GLATECT™ (glatiramer acetate)
KESIMPTA® (ofatumumab)
PLEGRIDY™ (peginterferon beta‑1a)
PONVORYTM (Ponesimod)
REBIF® (interferon beta-1a)
ORAL
AUBAGIO® (teriflunomide)
FAMPYRA™ (fampridine)
GILENYA® (fingolimod)
MAVENCLAD® (cladribine)
MAYZENT® (siponimod)
TECFIDERA™ (dimethyl fumarate)
ZEPOSIA® (ozanimod)
INFUSION
LEMTRADA® (alemtuzumab)
OCREVUS™ (ocrelizumab)
TYSABRI™ (natalizumab)
INJECTION
AVONEX™ (interferon beta-1a)
BETASERON® (interferon beta-1b)
COPAXONE® (glatiramer acetate)
EXTAVIA® (interferon beta-1b)
GLATECT® (glatiramer acetate)
KESIMPTA® (ofatumumab)
PLEGRIDY™ (peginterferon beta‑1a)
PONVORYTM (Ponesimod)
REBIF® (interferon beta-1a)
ORAL
AUBAGIO® (teriflunomide)
FAMPYRA™ (fampridine)
GILENYA® (fingolimod)
MAVENCLAD® (cladribine)
MAYZENT® (siponimod)
TECFIDERA™ (dimethyl fumarate)
ZEPOSIA® (ozanimod)
INFUSION
LEMTRADA® (alemtuzumab)
OCREVUS™ (ocrelizumab)
TYSABRI™ (natalizumab)
FORMS OF DMTs IN MS
For RRMS and SPMS, with relapses, the three most common ways to administer DMTs are the following:
Oral Medications
Pills, also known as oral medications, are a more recent development in relapsing MS treatment. They can be an effective alternative to infusions and injections. If you are afraid of needles, this may be an option to consider with your doctor.
Infusion treatments
Infusion treatments are administered intravenously (into a vein) through a needle in your arm. They are generally given less frequently than pills or injections and must be administered by a healthcare professional in a hospital, infusion centre, or doctor’s office.
Injectable therapies
Injectable therapies are one of the most common ways to help treat the symptoms of RRMS and SPMS, with relapses. Your doctor can show you, or your care partner, how to properly use a needle or autoinjector.
FREQUENCY OF THERAPY
The dosing schedule of a medication is another important factor to consider.
Depending on the form of therapy selected, choices may range from:
Managing MS requires
a comprehensive approach.
People living with MS may have physical, social, or emotional concerns. Patient programs and support groups (like those coordinated through the Multiple Sclerosis Society of Canada [MSSC]) offer a wide variety of resources.
Tips and advice
The best strategy for managing your MS is following the treatment plan you and your team have created. Along with healthy eating, regular exercise, rehabilitation, and other complementary therapies, sticking with the disease-modifying medication your doctor has prescribed is an important part of that plan.
DMTs are a class of drugs that influence the underlying disease activity.
DMTs may:
- Lessen inflammation
- Reduce the frequency and severity of relapses
- Reduce the number of new brain and spinal cord lesions
DMTs do not:
- Treat MS symptoms
- Cure MS
- Make people feel better
Sticking with DMTs over long periods of time may be challenging, as you may not be able to feel them working at all; however, they can be important to help slow disability progression.
Your doctor can help you be aware of the role DMTs play in your treatment plan and to watch out for obstacles that can make it hard to stick with them.
Talking to your kids about MS
Staying on track involves
several key elements:
Remembering when to take medication
Monitoring symptoms over time
Recording relapses
Overcoming medication fatigue
Learning injection techniques
Remembering when to take medication
- Take your medication, at the same time every day, along with another daily activity, like eating breakfast or brushing your teeth.
- Set a timed alarm or make a note in your calendar.
- There are many widely available smartphone medication adherence apps that can help you remember when to take your medication.
Monitoring symptoms
- Keep a journal of your MS symptoms. Write in it every day or when new symptoms appear, to help you have treatment plan discussions with your health care team.
There are many smartphone apps (iPhone and Android) that can help you record your symptoms.
Recording relapses
Sometimes a person may feel fine but then later experience an episode of worsening symptoms.
- These episodes are called relapses, exacerbations, flare-ups or attacks, and they may reveal important information about the status of your MS.
- It is important to keep track of when these relapses occur, how long they last and what symptoms you had, so your doctors can learn what is happening.
Medication fatigue
Taking DMTs over long periods of time can be challenging for many reasons. For some people, medication may feel like an unwanted reminder of their disease. MS patients may suffer from medication fatigue, (a decrease in commitment to follow the prescribed plan). It is important these emotions don’t get in the way, as following your plan can help preserve your health and improve your quality of life.
Injection techniques
While injections are common when it comes to MS medications, many people are afraid or anxious to self-inject.
Education on injection techniques can help build self-confidence and reduce this fear.
You can get information about injection techniques from qualified health care professionals or through the support programs offered by the manufacturer of your medications.
Check out the latest articles on current MS topics
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