There is currently no cure for MS, however there are a number of disease-modifying therapies (DMTs) that focus on reducing the number of relapses and modify disease progression. National guidance recommends offering DMTs as early as possible.

Category 1.1: Moderately effective

• Teriflunomide (Aubagio)
• Beta interferon 1a (Avonex, Rebif and Plegridy)
• Beta interferon 1b (Betaferon and Extavia)
• Glatiramer acetate (Copaxone, Brabio).

Category 1.2: More effective

• Fingolimod (Gilenya)
• Cladribine (Mavenclad)
• Dimethyl fumarate (Tecfidera).

Category 2.0: Highly effective

• Alemtuzumab (Lemtrada)
• Natalizumab (Tysabri)
• Ocrelizumab (Ocrevus).

Relapses

Most people diagnosed with MS get relapses. A relapse is defined as being when, after a stable period of at least one month, new symptoms develop or existing symptoms worsen for more than 24 hours in the absence of infection or any other cause.

NICE says treatment of a relapse should be with oral methylprednisolone 0.5g daily for five days, or intravenous methylprednisolone 1g daily for three to five days as an alternative administered in hospital. The aim is to reduce inflammation, shorten the duration of the relapse and to speed up recovery.