Is there a cure for multiple sclerosis (MS)?

With the emergence of new medications and therapeutic advances in MS care, people with MS may still live a fulfilled life.

Nondrug therapies and strategies may also help to manage MS symptoms.

What the science suggests 

Research to find a cure for MS is ongoing, and scientists are conducting studies to develop new medications. Developing a new drug involves using humans or animals, depending on the phase of the study.

For instance, ibudilast is an emerging medication that could potentially help people with progressive MS forms. In this phase 2 study among 255 people with MS, researchers found that ibudilast was associated with decreased progression of brain atrophy.

However, researchers found that people with MS using ibudilast had side effects like higher rates of depression, gastrointestinal problems, and headaches. There is no conclusive evidence showing the efficacy of ibudilast in treating people with MS.

Another innovative MS therapy is the use of high dose immunosuppression and autologous hematopoietic stem cell transplantation (HSCT) therapy. This procedure involves extracting and transplanting a person’s stem cells, which are produced in the bone marrow to enable the body to form new immune cells. Studies for HSCT therapy are still underway.

Medical management

Doctors typically use medications to manage MS to prevent disease progression.

Disease-modifying therapies (DMTs) are medications that can suppress the immune system and reduce the inflammation responsible for damaging the outer layer of the nerve cell(myelin), also known as demyelination. DMTs assist in decreasing the frequency of MS relapse, or disease progression, in recurrent MS cases.

DMTs may be oral tablets, injections, or intravenous infusions (IVs).

Examples of these drugs include: 

• fingolimod (Gilenya)
• interferon-beta preparations, like Avonex and Refib
•  natalizumab (Tysabri)
• glatiramer acetate (Copaxone)
• dimethyl fumarate (Vumerity)
• mitoxantrone (Novantrone)
• ocrelizumab (Ocrevus) 

Also, doctors may use corticosteroids such as prednisolone (Millipred) or methylprednisolone (Medrol) to reduce the intensity of inflammation in some people with MS.

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Nondrug therapy

Nondrug therapies are available for managing some MS symptoms. Some of the common ones include:

• Regular exercise, where possible: While some people with MS may find movement difficult, aerobic exercises and stretches provide structural support to organs, such as the bladder and intestines, that are often affected by MS.
• Balanced diet: A low fat and high fiber diet may reduce the risk of cardiovascular and metabolic disease that can worsen the symptoms and disease progression of MS.
• Acupuncture: This therapy could help reduce pain and fatigue for some people.
• Relaxation techniques: Mindfulness and yoga may help manage MS by reducing stress and promoting positive emotions.

Generally, doctors combine medications and nondrug remedies to achieve holistic care and to manage specific MS symptoms for each person.

How is the condition managed during a flare-up? 

If you have MS, you may sometimes undergo a flare-up or relapse, which means worsening current symptoms or having new ones.

Inflammatory reactions that damage the myelin sheath (coating) of nerves in the central nervous system typically cause MS relapses, causing a problem in nerve impulse transmission.

Doctors typically prescribe the following treatment options in cases of MS relapse:

• A short course of high dose corticosteroids, such as IV methylprednisolone or oral prednisone.
• Plasma exchange therapy called plasmapheresis can help to extract antibodies responsible for inflammation.
• Lifestyle modifications include healthy diets, physical activities, and psychosocial support systems.
• Rehabilitation care, such as physical therapy for those with significant muscular weakness.

The specific treatment plan for MS relapses may differ for each person and depends on the symptoms you experience.

MS and a healthcare team

MS management typically requires a multidisciplinary team of healthcare professionals due to the many different ways it can affect you.

In addition to a neurologist, some MS cases may require the services of specialist nurses, physical therapists, pharmacists, and exercise professionals.

These medical experts work together to improve your overall physical, mental, and emotional well-being.

Medical professionals may also carry out a patient-centered approach to your healthcare that achieves the following:

• promoting education about the condition among people with MS
• administration of various therapeutic interventions 
• rehabilitative care

Summary

MS does not yet have a cure, but researchers are conducting studies to develop new medications for the treatment.

An emerging MS therapy is autologous hematopoietic stem cell transplantation (HSCT) therapy. Studies are in progress to establish HSCT as a therapeutic option for MS.

Generally, doctors use DMTs and corticosteroids to reduce the inflammation responsible for nerve cell damage. 

Besides medications, lifestyle modifications such as a balanced diet, aerobic exercise (where possible), and mindfulness can help relieve some MS symptoms.

Medications and nondrug options are typically necessary for managing MS relapses.

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