Balancing the benefits and risks of treating MS

After getting diagnosed with MS, you’re probably wondering when is the best time to start treatment.

MS is an immune disorder where the immune system mistakenly attacks the central nervous system (brain, spinal cord, and optic nerves). The more damage that happens, the worse MS symptoms can become over time.

That’s why your healthcare provider may suggest that you begin treatment as soon as possible. Some people might want to wait and see if their symptoms get worse. Keep in mind that damage to the brain and spinal cord cannot be reversed.

It’s also important to understand that treatments like disease modifying therapies (DMTs) can’t treat symptoms. However, they may be able to delay the disease from getting worse (also known as disease progression). Even if you’re feeling well, it’s important to start treatment as soon as possible. The goal of treatment is to keep your MS from getting worse.

As you consider treatment options, you should talk to your healthcare provider about how each treatment may impact your overall life—not just your MS. This means considering the benefits and risks of each treatment. There may be a treatment that you are more comfortable taking than others. Ultimately, this will be a decision you make together with your loved ones and your healthcare provider.

Benefits

DMTs can be a very important factor in treating your MS. They have been shown to help reduce relapses, slow disability, and reduce the number of brain lesions.

Some benefits of treatment you might not have thought about include how often you take them, how they are given, and how you might feel from day to day.

There are many FDA-approved DMTs available, and they can be given in different ways. You could try asking your healthcare provider questions like:

• Are there different ways to take these medications?
• How often would I have to take them?

Remember, as with any medication, in order to see the full benefits of your treatment, it's important to take your medicine as prescribed. Not everyone's experience with DMTs is the same, so you may have to try a few options before finding one that's right for you.

Risks

Every treatment will have its own risks, and they may be different from the risks for other treatments. It’s important for you to not only understand these risks, but also to decide which risks you are willing to take.

Treatments like a DMT aim to work at the “root” of MS disease activity—and at the “root” there’s a problem with the immune system. Although we don't know how all DMTs work, it's thought that some may have an impact on the immune system. Be sure to ask your healthcare provider about side effects and how you can monitor them.

For some people, statistics may help them better understand side effects. You could try asking your healthcare provider questions like:

• How many people experienced serious side effects?
• How long have they been on this treatment?
• Are there any known long-term side effects?
• What is the chance that I will experience a certain side effect while taking this treatment?
• Do you know the number of people who had to stop this treatment because of side effects?

Depending on your lifestyle, there are also some other risks to consider. Other health conditions you may have, diet habits, or family planning can impact which treatment may work best for you. Consider asking your healthcare provider questions like:

• I take medicine for another health condition. How will this medicine affect my MS treatment?
• Does this medication affect vaccines?
• If I take a certain medication now, will it limit my ability to use other DMTs in the future?
• Do I need to change my diet or exercise plan?
• What if I’m planning to get pregnant in the future?

In certain instances, your healthcare provider may recommend switching to a different treatment. There are a number of reasons why this may happen, including:

• Your current treatment isn’t working as well as it should
• You’re experiencing side effects
• You're going through a life-changing event, which may include income changes, marriage or divorce, pregnancy, or health insurance coverage changes

As with any treatment, you should still talk about the potential benefits and risks even when you're switching. Remember, if a treatment isn't working for you, don't give up. MS is a marathon, not a sprint. Your healthcare provider is there to help you stay on track and find a treatment that's right for you. Please understand that you don't have to go through it alone.