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Chapter 3: Treating MS with a disease modifying therapy (DMT)


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Welcome to Understanding your MS, a series where people living with multiple sclerosis (MS) can learn more about their condition and the journey.

MS-certified Nurse Practitioner, Megan Weigel here.

In this video, I’m going to talk about disease modifying therapies (or DMTs).

This video is brought to you by Biogen, and I am compensated for my time. Your healthcare team is your best resource for information regarding your healthcare and treatment.

DMTs may be used in the treatment of MS. Currently, these medications are the most effective strategy to slow the progression of MS.

A DMT can come in many forms—as an injection, an infusion, or a pill.

Currently, there are several of these medicines approved by the FDA (the Food and Drug Administration). None of these medications can cure MS.

We don’t know why some people get MS and why others don’t. Or what causes it to start in the immune system. However, DMTs may play an important role in treating your MS.

DMTs do not treat your symptoms.

But, DMTs may help you in the long term by reducing relapses and the number of new or enlarging brain lesions. By doing this, DMTs may slow the progression of your MS.

If you’re prescribed a DMT, your healthcare team will most likely measure whether it’s working by evaluating the following 3 goals of treatment:

  • Reducing the number of new or enlarging lesions
  • Cutting the number of relapses
  • Slowing disability progression

Remember, MS is different for everyone. Not everyone responds to the same DMT the same way. You may have to try several different DMTs until you find the one that’s right for you.

If you do find a DMT that seems to be keeping you stable (and is meeting your treatment goals), then remaining on that treatment may be the best course forward. But this is a decision that you and your healthcare team will consider together.

It’s also important to keep in mind that DMTs do not improve current symptoms, and have both potential benefits and risks.

So be sure to talk with your healthcare team when choosing a DMT.

There is some evidence that suggests treating relapsing MS with a DMT early in your treatment journey may help. In fact, it might reduce physical disability progression.

In a 2016 study of 639 people with MS in Sweden, early treatment with a DMT resulted in a reduction of physical disability over an 8-year study period. In fact, people who started treatment later were 5% more likely to reach moderate disability for each year they delayed treatment.

Keep in mind that this is one study from outside the United States. Further research into the effectiveness of early treatment with DMTs is needed. Each patient is different. Individual results may vary. But it’s important to talk to your healthcare team about early treatment.

Another recent study observed 3,000 people with relapsing MS. Some of the people in the study had moderate disability. They experienced slower physical disability progression over 6 years when treated with a DMT.

As a reminder, this is one study and further research is needed. Each person living with MS is different. Individual results may vary. That’s why it’s so important to talk to your healthcare team about your DMT. And to check with them if it is still the right DMT for you.

It’s important to partner with your healthcare team to monitor your MS. There are a few ways to do this.

To start with, report any new or worsening symptoms. It will help your healthcare team monitor how you’re doing.

Next, if you’ve had a relapse, report it. Speak to your healthcare team as soon as possible. You may also want to ask if your current treatment plan is still the right one for you.

And third, be sure to stay informed about your MRI results. This includes talking to your healthcare team about any new or enlarging lesions or the progression of disability.

As discussed earlier, when all three of these areas remain unchanged, it can help to inform your healthcare team how well your treatment is working and whether or not you should consider a treatment change.

When preparing for visits with your healthcare team members, it’s important to plan ahead. One way is by writing a list of questions to ask. Here are some questions to help you get started. Keep in mind that these are only suggestions.

  • Do you see any signs of disease progression since my last appointment?
  • Do my MRI results reveal any changes?
  • When am I due for my next lab visit and MRI?

Remember, it’s important to bring up any changes in your condition with your healthcare team, even if they relate to your general health outside of your MS, your MS treatment, and your MRI results.

If you’re not currently taking a DMT, ask your healthcare team whether a treatment would be right for you. If you are taking a DMT, monitor your symptoms and any changes in your health status. And as always, work with your healthcare team to make sure your treatment is working for you.

Don’t forget Aby™ (the customizable free app from Biogen). Aby™ offers tools to help you monitor your MS and prepare for follow-up visits with your healthcare team.

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