24 MS DISEASE MODIFYING DRUGS
There are currently 24 disease-modifying medications approved by the FDA for use in relapsing forms and progressive forms of MS (secondary MS and primary progressive forms of MS. None of these medications cure MS but data suggests that they can decrease the number of MS relapses.
Keep in mind that every MS patient is different with their own unique variety of symptoms and timeline. Because of the increase of Disease Modifying Drugs patients are able to experience which of these drugs works for you! Discuss treatment options with your Neurologist to determine the best course of treatment for you.
With MS there is a range of unique symptoms based on where your lesions (scars) are located in your central nervous system. Physical symptoms might include pain, numbness, tingling, spasticity, walking and movement impairments.
Lesions in your brain might include cognitive challenges (invisible) symptoms such as fatigue, numbness, vision, coordination, memory, processing and speech. There are a host of symptom management medications and treatments available. See the Symptom Management page for a complete listing by symptom.
Both Disease Modifying and Symptom Management Medications and Specialty Treatments have a proven record of effectiveness. Talk with your neurologist to determine the best course of treatment for you.
Keep in mind that every MS patient is different with their own unique variety of symptoms and timeline. Because of the increase of Disease Modifying Drugs patients are able to experience which of these drugs works for you! Discuss treatment options with your Neurologist to determine the best course of treatment for you.
With MS there is a range of unique symptoms based on where your lesions (scars) are located in your central nervous system. Physical symptoms might include pain, numbness, tingling, spasticity, walking and movement impairments.
Lesions in your brain might include cognitive challenges (invisible) symptoms such as fatigue, numbness, vision, coordination, memory, processing and speech. There are a host of symptom management medications and treatments available. See the Symptom Management page for a complete listing by symptom.
Both Disease Modifying and Symptom Management Medications and Specialty Treatments have a proven record of effectiveness. Talk with your neurologist to determine the best course of treatment for you.
Momentum Magazine
Weighing the benefits, risks and side effects of each MS medication
New Bcell Treatments
How B-Cell Therapy Works B cells are a type of white blood cell. They make antibodies -- proteins that fight viruses and bacteria. B cells normally can’t cross from your blood into your brain or spinal cord. If you have MS, some B cells enter your brain and spinal cord and attack the myelin sheath that protects your nerves.
B-cell therapy uses drugs called monoclonal antibodies to attack these cells. These meds stick to the surface of B cells. This kills the cells, helps ease inflammation, and plays a part in slowing down nerve damage.B-cell therapy might affect other parts of your immune system as they fight MS. That’s because B cells affect other immune cells called T cells. T cells usually kill viruses and bacteria. But when you have MS, B cells recruit T cells into your brain. There, they cause inflammation.
When your number of B cells goes down, your amount of T cells that cause inflammation goes down, too. At the same time, your level of something called regulatory T cells goes up. Regulatory T cells turn off inflammation. They may even help slow your immune system’s attacks on your body.
Self Injectable Treatments
AVONEX (interferon beta-1a)-Biogen
30 mcg intramuscularly (into a large muscle) once weekly
For the treatment of relapsing forms of MS to slow the accumulation of physical disability and reduce the frequency of clinical exacerbation's, and for patients who have experienced a first clinical episode and have MRI features consistent with MS
BETASERON (interferon beta-1b)-Bayer Healthcare Pharmaceuticals Inc.
0.25 mg subcutaneously (under the skin) every other day
For the treatment of relapsing forms of MS
Approval RRMS 1993 US 1995 CAN, SPMS 1995 CAN
htts://www.betaseron.com
COPAXONE (glatiramer acetate)-Teva Neuroscience
20 mg subcutaneously every day, or 40 mg subcutaneously three times per week
For the treatment of relapsing forms of MS
Approval: 1996 US;
https://www.copaxone.com
EXTAVIA(interferon beta-1b)-Novartis Pharmaceuticals
25 mg subcutaneously every other day
For the treatment of relapsing forms of MS
Approval: 2009 US & Canada
www.extavia.com/index.jsp
http://www.pharma.us.novartis.com/info/products/brands/Extavia.jsp
EXTAVIA® Go Program 1-866-EXTAVIA (398-2842)
GLATOPA glatiramer acetate-Sandoz-Novartis Pharmaceuticals
generic 20 mg subcutaneously daily (generic for Copaxone )
For the treatment of relapsing forms of MS
Approval: 2015 US
www.glatopa.com
Kesimpta (ofatumumab, formerly OMB157)-Novartis Pharmaceuticals
20 mg monthly subcutaneous injections for relapsing forms of multiple sclerosis (RMS), to include clinically isolated syndrome and active secondary progressive disease
Approval: August 2020
www.novartis.com
Zunovo Ocrevus ocrelizumab and hyaluronidase-ocsq-Genentech
920 mg/23m injectable The first and only twice a year 10 minute subcutaneous injection for MS patients with Relapse Remitting, Secondary and Primary Progressive MS
Approval Sept 2024
www.gene.com/patients/medicines/ocrevus-zunovo
PLEGRIDY (pegylated interferonbeta-1a) Biogen
125 mcg subcutaneously every 14 days
For the treatment of relapsing forms of MS
Approval 2014
https://www.plegridy.com/en_us/l
REBIF® (interferon beta-1a) EMD Serono, -Pfizer, Inc.
44 mcg subcutaneously three times per week
For the treatment of relapsing forms of MS
Approval 1198 US 2002 CAN
http://www.rebif.com
ZINBRYTA™ (daclizumab) Biogen
150 mg once a month
For the treatment of adult patients with relapsing
Approval 2016 US
https://www.zinbryta.com
Oral Treatments
Aubagio (teriflunomide) Sanofi Genzyme
7 mg or 14 mg pill once daily
For the treatment of relapsing forms of MS
Approval 2012 US 2013 CAN
https://www.aubagio.com
Gilenya (fingolimod) Novartis Pharmaceuticals
0.5 mg capsule once daily
For the treatment of relapsing forms of MS
Approval 2010 US 2011 CAN
http://www.gilenya.com/index.jsp
Mavenclad EMD Serono
for the treatment of adults with relapsing forms of MS, including relapsing-remitting MS and active secondary progressive MS,
Mavenclad is a compound that targets certain types of white blood cells (lymphocytes) that drive the immune attack in MS.
Mavenclad is taken by mouth in two treatment courses, twelve months apart.
http://www.mavenclad.com
Mayzent Novartis International
approved for the treatment of adults with clinically isolated syndrome (an initial neurological episode) and relapsing forms of MS, including those with active secondary progressive MS.
https://www.novartis.com
Ponvory jasson- Johnson & Johnson
PONVORY® once per day prescription medicine that is used to treat relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
http://www.ponvory.com
Tecfidera (dimethyl fumarate) Biogen
120 mg capsule taken twice daily for one week, followed by 240 mg capsule taken
For the treatment of relapsing forms of MS
Approval 2013 US 2013 CAN
http://www.tecfidera.com/about
Vumerity-Biogen
VUMERITY® (diroximel fumarate) is a prescription medicine used to treat people with relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease in adults. It is not known if VUMERITY is safe and effective in children.
https://www.vumerity.com/
Zeposia® (ozanimod) Bristol-Myers Squibb
once daily oral medication for the treatment of relapsing forms of multiple sclerosis. Treatment for relapsing forms of multiple sclerosis (RMS), Secondary Progressive (SPS) and clinically isolated syndrome (CIS)
taken once daily and is the only approved sphingosine-1-phosphate (S1P) receptor modulator that offers RMS patients an initiation with no genetic test and no label-based first-dose observation.
https://www.zeposia.com
Intravenous Infusion Treatments
Briumvi (ubliuximab)) TG Therapeutics
For the treatment of relapsing forms of multiple sclerosis (RMS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
Briumvi is a monoclonal antibody that targets CD20, a protein found on the surface of B cells, and induces B-cell depletion within 24 hours. B cells are white blood cells shown to play a role in MS.
Briumvi can be administered in a one-hour infusion following the starting dose. The administration schedule of Briumvi consists of a day one infusion of 150mg administered in four hours, a day 15 infusion of 450mg administered in one hour, followed by 450mg infusions every 24 weeks administered in one hour.
Pre-dosing Tests
Individuals prescribed Briumvi are required to have blood tests to screen for the presence of Hepatitis B virus (HBV), and for serum levels of immunoglobulins.
Possible Side effects:
The more common side effects of this drug can include:
- fever
- chills
- headache
- flu-like symptoms
- upper or lower respiratory tract infections
- Herpes virus-associated infections
- pain in your arms or legs
- difficulty sleeping (insomnia)
Lemtrada (alemtuzumab) Sanofi Genzyme
12 mg per day for five consecutive days, followed by 12 mg per day on three consecutive days one year later
For the treatment of relapsing forms of MS
Approval 2014 US and CAN
Patients must be enrolled in the LEMTRADA REMS (Risk Evaluation and Mitigation Strategy) Program to be able to take LEMTRADA
Possible side effects
The more common side effects of this drug can include:
- rash
- headache
- fever
- common cold
- nausea
- urinary tract infection (UTI)
- fatigue
- autoimmune reactions, such as Guillain-Barré syndrome and organ failure
- cancer
- blood disorders
Mitoxantrone Bedford Pharmaceuticals
Available only as a generic medication No brand name available
12 mg/m² every 3 months. Lifetime cumulative dose limit of approximately 8–12 doses over 2–3 year
For reducing neurologic disability and/or the frequency of clinical relapses in patients with secondary (chronic) progressive, progressive relapsing or worsoning relapsing remitting MS
Approval 2000 US
The more common side effects of this drug can include:
- low WBC levels, which may increase your risk of infections
- depression
- bone pain
- nausea or vomiting
- hair loss
- UTI
- amenorrhea, or a lack of menstrual periods
- congestive heart failure
- kidney failure
- blood issues
https://www.google.com/search?q=Frequency+of+(mitoxantrone)+infusion+fior+multiple+Sclerosis&ie=utf-8&oe=utf-8
OCREVUS (ocrelizumab) Genentech USA
B Cell Therapy
This treatment offers hope to patients with the most severe form of the progressive disease.
The intravenous drug, made by Genentech, given every six months, appeared to slow progression of a more severe type of the disease, called primary progressive MS.
The more common side effects of this drug can include:
- infections
- infusion reactions
- PML
- reactivation of hepatitis B or shingles, if they’re already in your system
- a weakened immune system
- cancer, including breast cancer
http://www.cbsnews.com/news/multiple-sclerosis-drug-ocrevus-ocrelizumab-fda-approved/
https://www.ocrevus.com
TYSABRI (natalizumab) Biogen
300 mg once every 28 days. Must take place in an approved infusion facility
For the treatment of relapsing forms of MS
Approval 2006 US and CAN
https://www.tysabri.com/en_us/home/about/overview.html?cid=ppc-ggl-branded-na-19-branded
Tysabri and the JC Virus-PML -What you need to know....
It was recently posted that the on-set of PML is now 1 out of 250 patients who have tested positive for the JC virus and are taking Tysabri infusions.
Before your doctor prescribes Tysabri you will need to take the JCVirus blood test to determine if you are positive or negative
If you test positive for the JCVirus, you should talk yo your Doctor about the increased risk.
http://ms.about.com/od/treatments/a/Testing-For-Jc-Virus-Antibodies-For-Tysabri-Related-Pml-Risk.htm
Also If you tested positive for the JCV, there is a blood test available (STRATIFY) that shows the % of risk for PML
If you are at low risk 2.0 or less, your neurologist may decide to keep you on Tysabri.
The more common side effects of this drug can include:
- infections
- allergic reactions
- headache
- fatigue
- depression
- a rare and deadly brain infection called progressive multifocal leukoencephalopathy (PML)
- liver problems, with symptoms such as:
- yellowing of your skin or the whites of your eyes
- dark or brown (tea-colored) urine
- pain in the upper right side of your abdomen
- bleeding or bruising that occurs more easily than normal
- tiredness
- urinary tract infection (UTI)
(Required) Tysabri Touch Program 800-456-2255
http://www.tysabri.com/corporate/microsites/tysabri/ms-assessment-tool.html
Other Infusion Treatments
In some cases, your doctor may suggest infusion treatments that don’t also function as disease-modifying drugs for MS. They include:
- Plasmapheresis. Plasmapheresis involves removing blood from your body, filtering it to remove antibodies that may be attacking your nervous system, and sending the “cleansed” blood back into your body through a transfusion.
- Intravenous immunoglobulin (IVIG). In IVIG therapy, you receive blood plasma donations from people without immune conditions. This transfusion helps boost your own immune system.
- Rituximab (Rituxan). This treatment works by targeting white blood cells known as B lymphocytes. It’s traditionally used to help treat conditions such as rheumatoid arthritis, non-Hodgkin’s lymphoma, and chronic lymphocytic leukemia.
- Methylprednisolone (Solu-Medrol). Methylprednisolone is a potent anti-inflammatory steroid. Like other steroids for MS, it works by helping to prevent inflammatory cells from crossing into the CNS.
Specialty MS Treatments (Washoe County, NV)
Acupuncture
8 Dimensions-Brook Hollinger
PTNS-Tibial Nerve Stimulation
8dimensionsreno.com
The Finley Center
http://www.thefinleycenter.com/
Renown Medical Acupuncture
Acupuncture@renown.org
775-982-8255
Symmetry Acupuncture
http://symmetryacupuncture.com/
775-329-5100
Dry Needling
Align Physical Therapy
http://www.alignptgroup.com/
(775) 360-5564
Cannabis Medical
Medicating with Mary
Medicinal cannabis is ENTIRELY different than recreational Cannabis
www.marymedibles.com
Cognitive Testing & Treatment
Peak Neuropsychology, Reno
https://www.peakneuropsychology.com
775-420-4320
421 W. Plumb Ln., Ste. B, Reno, NV
Neuropsychological Assessment
Changes in cognition can be symptomatic of a neurodegenerative disease process. A neuropsychological assessment can help patients and providers identify underlying causes of cognitive or behavioral changes, including neurodegenerative conditions such as Alzheimer’s disease, Parkinson’s disease, Lewy body disease, frontotemporal disorders, primary progressive aphasia, progressive supranuclear palsy, Multiple Sclerosis, and cerebrovascular disease.
Summit Neuropsychology-Evaluation only
summitneuropsychology.com
9645 Gateway Dr., Reno
775-525-1347
Changes in cognitive function, mood, behavior, and productivity due to neurological events such as stroke, anoxic accidents, Multiple Sclerosis, Parkinson’s disease, chronic substance use, and neurotoxicity.
Reno Tahoe Therapy Group-Evaluation & Therapy
www.facebook.com/reno.carson.speech therapy
3697 Kings Row Ste#C, Reno
775-400-2322
Your team of professionals that is passionate about making positive changes, in individuals lives. Our goal is to empower each individual to progress in an effective, fun, and rewarding way.
Hyperbaric Oxygen Therapy
www.nevadahyperbarics.com/
(775) 826-2084
www.mayoclinic.com/health/hyperbaric-oxygen-therapy/my00829
Physical Therapy
Align Physical Therapy
http://www.alignptgroup.com/
(775) 360-5564
Back in Motion
http://www.backinmotion.net/
(775) 746-2206
Renown Physical Therapy
https://www.renown.org/explore/transitional
775-982-2781
St Mary's Health & Fitness Center
https://www.saintmarysfitness.com/
775-770-3800
Speech Therapy
Renown Health-775-982-5000
Multi-Service
Sierra Integrated Medical Center
MS, Parkinson’s & Motor Neuron Diseases
http://www.sierraintegrative.com/clients/ogorman.htm
Pharmaceutical - Financial Assistance Foundations
Acthar GEL
Patient Assistance Program
www.acthar.com
(888) 435-2284
AMPYRA Patient Assistance Program
(APAP) 1-866-565-7796
Kimberly S. Guldan
Reimbursement Case Specialist
Assistance Fund
877‐245‐4412
theassistancefund.org 4.
AVONEX -MS ActiveSource
(800) 456-2255
www.avonex.com
Bayer HealthCare Pharmaceuticals-Betaseron
https://www.betaseron.com/betaplus/affordabilit
1-800-788-1467
Biogen- Tysabri-Patient Financial Assitance
https://www.biogenoptions.com/en_us/home/biogen-support-services/financial-insurance-cost-assistance.html
Chronic Disease Fund
1-877-968-7233
http://www.cdfund.org/
coverageforall.org
Foundation for Health Coverage
800‐234‐1317
Genzyme-Aubagio
Patient Assistance Program
https://www.aubagio.com/aubagio-copay
Good Days
1-877-968-7233
Healthwell Foundation
800‐675‐8416
MS ActiveSource 1-800-456-2255
Biogen-Avonex, Gilenya Plegridy,Tecfidera, Tysabri,
$10 co-pay program only eligible to non Medicare or Medicare Advantage part D insured
http://www.tysabri.com/tysabri-cost-and-support.xml
MS Lifelines
877-447-3243
Needy Meds
http://www.needymeds.org/inclusions/pap.htm
Patient Support 877-447-3243
Nord Financial Assistance Program
https://www.rarediseases.org/patients-and-families/patient-assistance
1-888-435-2284
Novartis-Extavia
http://www.extavia.com/info/Treatment/How-is-extavia-cost.jsp
MS ActiveSource: 1-800-456-2255
Novartis-Gilenya
http://www.gilenya.com/c/paying-for-gilenya
Ntl Organization for Rare Disorders (NORD)‐
202‐588-5700
Patient Access Network Foundation
http://www.panfoundation.org/disease-funds-main-page
1-866-316-7263
Pfizer-Rebif
http://www.rebif.com/rebif-financial-services
MS LifeLines 1-877-447-3243
rarediseases.org
Rebif - MS LifeLines
(877) 447-3243
www.MSLifeLines.com
Rx Outreach
800‐769‐3880
rxoutreach.org 5.
Serono Labs-Novantrone
www.needymeds.org/drug_list.taf?_function=name&name=Novantrone
Patient Support 877-447-3243
Teva Neuroscience- Copaxone
Shared Solutions
https://www.copaxone.com/shared-solutions/copaxone-co-pay
US BioServices
http://www.usbioservices.com/
877-757-0668