← Master Index· Section 9 · Neurologic Disorders · Chapter 56

Multiple Sclerosis

Multiple SclerosisRRMSDMTDemyelination

30-Second Snapshot

What it is:Multiple sclerosis is an autoimmune disease where the immune system attacks the myelin sheath and the axons themselves in the central nervous system (brain, spinal cord, optic nerves). The true trigger is unknown, but the working theory is a T-cell and B-cell driven attack against myelin and oligodendrocytes (the cells that make myelin), amplified by macrophages, antibodies, and reactive oxygen species.

The core problem:Every lesion is a patch of stripped or damaged wiring. Strip the insulation off a wire and the signal slows, degrades, or stops. Where the lesion forms determines the symptom, which is why MS can look like almost anything neurologic depending on the patient and the moment.

What you do about it:Three separate jobs, not one. (1) Shorten and soften acute attacks with high-dose steroids. (2) Slow the underlying disease with a disease-modifying therapy (DMT), started as early as possible. (3) Manage the symptoms that are already there (spasticity, bladder issues, fatigue) because DMTs don't touch existing damage.

Worth knowing

Think of MS management as three separate prescriptions running in parallel: a steroid burst is damage control for a flare, a DMT is the long game against future flares and silent progression, and symptomatic drugs treat whatever damage is already permanent. Mixing these up is the single most common way students get MS questions wrong; a steroid taper does not modify long-term disease course, and a DMT does not touch today's relapse.

Classify First - Course Determines Everything

MS is classified by how the disease behaves over time, not by a single scan or lab value. The classification a patient carries drives which drugs are even on the table.

CoursePatternNotes
RRMS(relapsing-remitting)Discrete attacks (new symptoms lasting at least 24 hours) followed by full or partial recovery, with stable baseline between attacksMost common presentation at diagnosis; most DMTs are approved here
SPMS(secondary-progressive)Steady decline that follows an initial relapsing-remitting courseMost RRMS patients eventually convert to this; attacks and remissions become hard to distinguish from background progression
PPMS(primary-progressive)Progressive disability from the moment of diagnosis, no distinct relapsesSmaller subset; far fewer approved DMTs (ocrelizumab is the standout)
CIS(clinically isolated syndrome)A single episode suggestive of MS, not yet meeting full diagnostic criteriaRisk-stratified by MRI/LP into low-risk (watch and wait) vs high-risk (treat)
RIS(radiologically isolated syndrome)MRI lesions typical of MS found incidentally, no clinical symptoms at allMonitored clinically and radiographically rather than treated
The distinction that gets tested

RRMS relapses are episodic and at least partially reversible; SPMS/PPMS progression is continuous and does not remit.A relapse must last ≥24 hoursand reflect new or worsening neurologic function to count. Also remember: mitoxantrone is FDA-approved for SPMS and worsening RRMS but is essentially never usedbecause of the risk of secondary leukemia and cardiotoxicity. If a question dangles it as an answer for a young patient with mild disease, that's the trap.

Pathophysiology - Why the Drugs Work

The exact cause of MS is still unknown, but the accepted model is autoimmune: the immune system misidentifies myelin (and the oligodendrocytes that produce it) as foreign and mounts a sustained attack. The actual executioners of tissue damage haven't been pinned to one single culprit; it's some combination of activated macrophages, autoantibodies, inflammatory cytokines, and reactive oxygen intermediates converging on the same targets.

Lesions are not identical from patient to patient, or even from lesion to lesion in the same patient. That heterogeneity reflects differences in how far along a lesion is (early inflammatory vs old, burned-out) and possibly differences in the underlying immune mechanism driving it. This is part of why MS is so unpredictable and why "one size fits all" therapy doesn't exist.

The unlock

Nearly every DMT class works by interrupting some step of immune cell activation, migration into the CNS, or survival, either by modulatingthe immune signal (interferons, glatiramer acetate, S1P modulators, fumarates, teriflunomide) or by suppressing/depletingimmune cells directly (natalizumab, the anti-CD20s, alemtuzumab, cladribine, mitoxantrone). None of these drugs repair existing demyelination. They only reduce the rate of new attacks and new lesion formation, which is exactly why early treatment matters: axonal damage that has already happened is largely irreversible.

Clinical Presentation

Presentation is wildly variable between patients and even within the same patient over time, because it depends entirely on where the lesions happen to land. Signs and symptoms are grouped into three tiers, and knowing the tier tells you what you're actually treating.

TierWhat it isExamples
PrimaryDirect result of demyelination itselfOptic neuritis/visual complaints, gait problems and falls, paresthesias, pain, spasticity, weakness, ataxia, speech difficulty, cognitive and psychological changes, fatigue, bowel/bladder dysfunction, sexual dysfunction, tremor
SecondaryComplications that arise because ofthe primary symptomsRecurrent UTIs, urinary calculi, decubitus ulcers, osteomyelitis, osteoporosis (from immobility), respiratory infections, poor nutrition, depression
TertiaryThe ripple effect of chronic illness on a person's lifeFinancial strain, social/relationship strain, vocational loss, emotional burden
Easy to confuse

Secondary symptoms are not "less important" symptoms, they're downstream consequencesyou can often prevent. A patient with neurogenic bladder (primary) who isn't catheterized properly ends up with recurrent UTIs and calculi (secondary). That's a counseling and monitoring opportunity, not just a primary-symptom problem.

Diagnosis - A Diagnosis of Exclusion

There is no single confirmatory test for MS. Diagnosis leans on ruling out mimics, because plenty of other neurologic diseases can look like MS, and MS itself can mimic other syndromes. Formal work-up lands a patient in one of three buckets: MS(RRMS or PPMS), possible MS, or not MS. Getting to "MS" generally requires at least two separate episodes of neurologic disturbance that reflect distinct CNS damage not explained by anything else.

The supporting evidence

How the workup actually gets used

A first attack alone (CIS) isn't automatically "MS." The MRI (with or without LP) is used to risk-stratify: low risk of further attacksmeans watch and wait, high risk(more lesions, more inflammatory burden) means treatment is considered right away. This is the diagnostic decision point where a lot of the DMT-timing questions live.

Treatment Goals & The Three Buckets

Goals of treatment:improve overall quality of life, help the patient maintain employment, and minimize long-term disability. None of the current therapies cure MS or reverse existing damage.

Everything pharmacologic in MS sorts into exactly three buckets:

BUCKET 1

Treat Exacerbations

High-dose glucocorticoids shorten an attack and may lessen its severity. Doesn't change the long-term trajectory.

BUCKET 2

Disease-Modifying Therapy

Alters the course of illness, reduces relapse frequency and new lesion formation, slows progression of disability over time.

BUCKET 3

Symptomatic Therapy

Manages spasticity, bladder symptoms, sensory symptoms, and fatigue that are already present. Required even on a good DMT.

Nonpharmacologic care runs alongside all three: occupational therapyteaches new techniques and tools for daily living tasks, and physical therapyimproves strength, gait, and balance while stretching reduces spasms. Mobility aids (canes, walkers) support independence as disability accumulates.

Worth knowing

Whether a patient starts on a lower-efficacy agent and escalates only if they break through (escalation approach) or starts on a high-efficacy agent up front (induction approach) depends on how severe the disease looks at initial presentation. This is a clinical judgment call, not a fixed rule, and it's exactly the kind of nuance the DMT algorithm (see Algorithm & Switching) is built around.

Treating Exacerbations - Glucocorticoids

Relapses worth treating are those that are mono- or polysymptomatic, localized to the optic nerve, spinal cord, or brainstem, cause functional limitations affecting activities of daily living, or worsen progressively over a 2-week window. Not every minor symptom flicker needs a steroid burst.

AgentDoseNotes
Methylprednisolone IV500-1000 mg/day IV for 3 days, occasionally up to 10 daysThe workhorse. Starting within 2 weeksof symptom onset speeds functional recovery, with improvement typically beginning by 3-5 days
Oral prednisone or dexamethasoneEquipotent dosing to IV methylprednisoloneCan substitute for IV therapy; dexamethasone has weaker literature support
ACTH-The only agent formally FDA-approved specifically for MS exacerbations, but rarely used given cost and limited availability
Adverse effects to expect

Sleep disturbance, a metallic taste in the mouth, and occasionally mild GI upset. These are common and usually tolerable given the short course; warn the patient up front so it doesn't derail adherence to the taper.

Disease-Modifying Therapy - Dosing Table

DMTs split into first-generation(interferons and glatiramer acetate, the original self-injectables) and second-generationagents (orals and newer infusions/injectables with generally higher efficacy but more monitoring burden). Every one of these is a specialty medication, dispensed only through specialty pharmacy, typically running $100,000/year or more.

Drug (Brand)RouteIndicationInitial / TitrationMaintenance Dose
First-generation - self-injectable
Interferon β-1a (Avonex)IM weeklyRelapsing MS30 mcg (6 million IU) weeklySame - "low-potency" interferon
Interferon β-1a (Rebif)SQ 3x/weekRelapsing MS22 mcg 3x/week22 or 44 mcg 3x/week - "high-potency" interferon
Interferon β-1b (Betaseron, Extavia)SQ every other dayRelapsing MS250 mcg (8 million IU) every other daySame - "high-potency" interferon
Peg-interferon β-1a (Plegridy)SQ every 14 daysRRMS6.3 mcg day 1, 94 mcg day 15, 125 mcg day 29125 mcg every 14 days
Glatiramer acetate (Copaxone, Glatopa)SQCIS, RRMS-20 mg daily or40 mg 3x/week
First-generation - IV infusion
Mitoxantrone (Novantrone)IVSPMS, worsening RRMS-12 mg/m² every 3 months; lifetime max 140 mg/m²
Second-generation - oral
Fingolimod (Gilenya)Oral dailyRelapsing MS, age ≥10-Adult 0.5 mg daily; peds <40 kg 0.25 mg, >40 kg 0.5 mg
Siponimod (Mayzent)Oral dailyRelapsing MS5-day up-titration (dose depends on CYP2C9 genotype)*1/*1, *1/*2, *2/*2: 2 mg daily. *1/*3, *2/*3: 1 mg daily
Ozanimod (Zeposia)Oral dailyRelapsing MS0.23 mg days 1-4, 0.46 mg days 5-70.92 mg daily from day 8
Ponesimod (Ponvory)Oral dailyRelapsing MS14-day up-titration, 2 mg → 10 mg20 mg daily from day 15
Dimethyl fumarate (Tecfidera)Oral BIDRelapsing MS120 mg BID x 7 days240 mg BID
Diroximel fumarate (Vumerity)Oral BIDRelapsing MS231 mg BID x 7 days462 mg BID
Monomethyl fumarate (Bafiertam)Oral BIDRelapsing MS95 mg BID x 7 days190 mg BID
Teriflunomide (Aubagio)Oral dailyRelapsing MS-7 or 14 mg daily
Cladribine (Mavenclad)Oral, pulsedRRMS, active SPMS2-year course, 1.75 mg/kg/year in 2 short cycles/yearNo dosing for 2 years after the 2-year course completes
Second-generation - IV infusion
Natalizumab (Tysabri)IVRelapsing MS-300 mg every 4 weeks (REMS required)
Alemtuzumab (Lemtrada)IVRRMSCourse 1: 12 mg/day x 5 daysCourse 2 (12 mo later): 12 mg/day x 3 days (REMS required)
Ocrelizumab (Ocrevus)IVRelapsing MS and PPMS300 mg, then 300 mg 2 weeks later600 mg every 6 months (REMS required)
Second-generation - self-injectable
Ofatumumab (Kesimpta)SQRelapsing MS20 mg weekly x 3 doses (wks 0, 1, 2)20 mg monthly starting week 4
High-yield indication quirks

Ocrelizumab is the only DMT with an approved PPMS indication.Mitoxantroneis the only one indicated for worsening progressive disease but is avoided due to secondary leukemia risk and a hard lifetime dose cap. Cladribine has a built-in "off" period: after the 2-year, 4-cycle course, no oral cladribine is given for the next 2 years, a dosing pattern unlike anything else on this table.

Class-by-Class Detail

First-generation agents: interferons & glatiramer acetate

These are the original DMTs and are immunomodulatory, meaning they shift immune signaling without direct cytotoxic or bone-marrow-suppressive effects. Interferons come in "low-potency" (Avonex) and "high-potency" (Rebif, Betaseron/Extavia) tiers based on dosing frequency and magnitude. Glatiramer acetate is the one non-interferon first-generation agent; Glatopa is simply the generic version of Copaxone.

Depression warning

Both interferon-β1a and interferon-β1b carry a caution around depression and should be avoided in patients with untreated severe depression. This is a real prescribing gate, not just a side-effect footnote.

Injection-site reactionsare common across all the self-injectables, and glatiramer acetate specifically carries a risk of tissue necrosis at the injection site plus a post-injection reaction (chest tightness, flushing, palpitations) that can occur unpredictably at any dose.

Oral S1P receptor modulators: fingolimod, siponimod, ozanimod, ponesimod

This whole family works by trapping lymphocytes inside lymph nodes so fewer of them ever reach the CNS to cause damage. That mechanism is exactly why the adverse effect list across the group repeats itself: lymphocytopenia, infections, and cardiac conduction effects (bradyarrhythmia, AV block) because of shared receptor activity, plus macular edema and decreased pulmonary function.

First-dose observation & cardiac contraindications

Fingolimod requires first-dose observationfor bradycardia/AV block. It's contraindicated with Class I/III antiarrhythmics and in patients with recent cardiac disease or second/third-degree AV block. Ketoconazole raises fingolimod levels via 3A4 inhibition.Ponesimod requires similar cardiac screening, with a 4-hour observation window in patients with certain preexisting cardiac conditions (recent MI, unstable angina, stroke/TIA, decompensated HF, second/third-degree AV block, sick sinus syndrome).

Siponimod is unique for requiring CYP2C9 genotype testing before the first dose, since both the titration schedule and the maintenance dose depend on genotype, and it's contraindicated in the *3/*3 genotype altogether. It also interacts with 2C9 and 3A4 inhibitors/inducers.

All four require baseline and ongoing varicella zoster antibody testing, ECG, blood pressure, ophthalmic exam (for macular edema), CBC, and LFTs.Vaccine efficacy can be blunted while on fingolimod; live vaccines should be avoided during and for a period after ozanimod.

Fumarates: dimethyl, diroximel, monomethyl fumarate

All three fumarates share flushing and GI upset as their signature nuisance effects, plus lymphocytopenia, elevated LFTs, albuminuria, and a rare but serious risk of PML.

Counseling fix for flushing

Taking the dose with food measurably decreases flushingwith dimethyl fumarate. This is a concrete, actionable counseling point that keeps patients adherent through the early weeks.

Diroximel fumarate and monomethyl fumarateare newer entries designed around the same active pathway but with less GI adverse effect burden than dimethyl fumarate, which is their main selling point when a patient can't tolerate the original. Monitoring across the class is CBC, LFTs, and MRI.

Teriflunomide & cladribine - the "high caution" orals

Teriflunomideis the active metabolite of leflunomide (used in rheumatoid arthritis), which explains its overlapping toxicity profile: hepatotoxicity, Stevens-Johnson syndrome, neutropenia, TB reactivation risk, and peripheral neuropathy. It's pregnancy category Xand contraindicated in severe hepatic impairment. If rapid elimination is ever needed (pregnancy, serious adverse reaction), cholestyramine or activated charcoal accelerates clearance, since teriflunomide otherwise lingers in circulation for a long time.

Cladribine contraindications

Contraindicated with current malignancy, HIV or other active chronic infection, and in pregnancy or lactation. Contraindicated in females and males of reproductive potentialmore broadly, given mutagenic risk. Lymphocyte counts must be within normal limits before the first course and above 800 cells/mm³before the second. Requires HIV, HBV, HCV, and TB screening plus VZV antibody and pregnancy testing before starting.

Natalizumab - the PML drug

Natalizumab blocks α4-integrin (VLA-4), preventing activated lymphocytes from adhering to and crossing the blood-brain barrier. Highly effective, but its defining risk is progressive multifocal leukoencephalopathy (PML), a potentially fatal JC virus reactivation in the brain.

JCV status drives everything

Natalizumab is reserved for patients who are JCV-antibody negative, or JCV-positive only when the benefit clearly outweighs the "severe but low" PML risk, per guideline language, with an antibody index above 0.9 requiring the most caution. This is why JCV testing sits directly in the treatment algorithm(see next section) rather than being an afterthought. A REMS program is mandatory. Discontinuing natalizumab in a patient who develops PML also carries a risk of immune reconstitution inflammatory syndrome (IRIS)as immune surveillance of the CNS returns.

Monitoring: JCV antibody status, ongoing infection screening, MRI, LFTs, and watching for hypersensitivity reactions during infusion.

Anti-CD20s: ocrelizumab, ofatumumab, and B-cell depletion with rituximab

These deplete CD20-positive B cells, reflecting the growing recognition that B cells (not just T cells) drive MS pathology. Ocrelizumabis infused every 6 months after the loading doses and is the only DMT with a formal PPMS indication. Ofatumumabis notable for being self-injectabledespite being a B-cell depleting biologic, dosed monthly after a 3-dose loading series.

Infusion prep matters

Ocrelizumab infusions require premedicationwith an antihistamine 30-60 minutes prior plus IV methylprednisolone (or equivalent) 30 minutes prior, with observation for at least 1 hour post-infusion given the risk of infusion reactions. Both agents require hepatitis B screening before the first doseand avoidance of live vaccines during and after treatment until B-cell counts recover (give live vaccines at least 6 weeks before starting for ocrelizumab, or 4 weeks before for ofatumumab; inactivated vaccines at least 2 weeks before for ofatumumab).

Ofatumumab additionally requires monitoring of serum immunoglobulins, since chronic B-cell depletion can reduce them over time and raise infection risk.

Alemtuzumab - highest efficacy, highest autoimmune baggage

Alemtuzumab depletes CD52-positive lymphocytes broadly and is reserved for highly active disease, typically after other therapies have failed, given the depth of immune suppression it causes.

The trade-off

Because it wipes out such a broad swath of the immune system, alemtuzumab carries risk of secondary autoimmune disorders(thyroid disease, immune thrombocytopenic purpura, Goodpasture syndrome) that can appear months to years after infusion, plus significant infection risk. Premedicate with 1,000 mg methylprednisolone(or equivalent) immediately before infusion for the first 3 days of each course, and give herpes viral prophylaxisstarting day 1 of treatment, continued for at least 2 months after completion or until CD4+ count is at least 200 cells/mm³, whichever is later. REMS program required. Contraindicated with HIV infection.

Reproductive counseling:contraception should be used during treatment and for 4 months after each treatment course; nursing is not recommended during that same window.

Mitoxantrone - the one nobody uses anymore

An anthracenedione that suppresses bone marrow broadly. Approved for SPMS and worsening RRMS, but its use has essentially disappeared because of a lifetime cumulative dose cap of 140 mg/m²(cardiotoxicity) and a real risk of treatment-related acute myeloid leukemia (AML). Monitor CBC, ECG, LVEF, and LFTs. If it shows up as a treatment answer for a young, mildly affected patient, it's almost always the wrong choice on an exam.

Algorithm, Switching & Access

The management algorithm starts the moment a patient presents with symptoms suggestive of MS and branches based on MRI findings, disease activity, and JCV status.

Key recommendations to memorize
  • Start an FDA-approved DMT as soon as possibleafter a definite RRMS diagnosis; can also be considered after a first clinical attack once other causes are excluded, and in PPMS with relapses or inflammatory activity.
  • Continue therapy indefinitelyunless there's clear lack of benefit, intolerable adverse effects, poor adherence, new safety data, or a better option becomes available.
  • Absence of relapses on treatment is not, by itself, a reason to stop.When switching for suboptimal response, move to a drug with a different mechanism of action.
  • Highly active MS→ alemtuzumab, fingolimod, or natalizumab are the named options.
  • Ocrelizumab can be offered for PPMSwhen benefit outweighs risk.
  • Access should not be gated by relapse frequency, age, other personal characteristics, or level of disability, and therapy should not be delayed while awaiting payer coverage determinations, since that delay itself puts the patient at risk.

Pregnancy, Vaccines & PML Surveillance

Pregnancy and reproductive planning

Vaccines

Complementary/alternative therapies

Antioxidant supplements (vitamins A, C, E, alpha-lipoic acid, coenzyme Q10, grape seed and pine bark extract, mangosteen, acai) have suggestive but unproven benefit, and carry a theoretical risk of stimulating the immune system further, which is exactly the opposite of what you want in an autoimmune disease. Frame this honestly with patients who ask about supplements.

Symptomatic Management

DMTs don't touch symptoms that are already present. These are treated on their own track, often by symptom rather than by "MS" as a diagnosis.

SymptomAgents used
SpasticityBaclofen, dantrolene, diazepam, clonazepam, tizanidine, tiagabine, gabapentin, pregabalin, botulinum toxin type A, dalfampridine
Bladder symptomsPropantheline, oxybutynin, dicyclomine, DDAVP (desmopressin), imipramine, amitriptyline, prazosin, terazosin, botulinum toxin type A, solifenacin, darifenacin, trospium, hyoscyamine, mirabegron, tamsulosin, tolterodine, or self-catheterization
Sensory symptomsCarbamazepine, phenytoin, amitriptyline (and other TCAs), gabapentin, lamotrigine, pregabalin, duloxetine
FatigueAmantadine, antidepressants, modafinil, methylphenidate, dextroamphetamine, armodafinil, fluoxetine
Worth knowing

Notice how much overlap there is with other therapeutic areas: the bladder list borrows heavily from overactive bladder management, the sensory-symptom list is basically the neuropathic pain toolbox, and the fatigue list leans on stimulants and wake-promoting agents. You already know most of these drugs; the skill here is recognizing when a "different" chief complaint is actually MS-driven.

Monitoring - What, When, Why

ParameterWhenWatching for
CBCBaseline and periodically on nearly every DMTLymphocytopenia, neutropenia, bone marrow suppression (varies by agent)
LFTsBaseline, then per-agent schedule (e.g., interferons: baseline, 1 month, every 3 months for a year, then every 6 months)Hepatotoxicity, especially with interferons, fumarates, teriflunomide, cladribine
ECG / cardiac monitoringBaseline and with first dose for S1P modulators; ongoing for mitoxantroneBradyarrhythmia, AV block, LVEF decline
Ophthalmic examBaseline and periodically on S1P modulatorsMacular edema
JCV antibody statusBefore starting and periodically during natalizumabPML risk stratification
Varicella zoster antibodyBefore starting S1P modulators and alemtuzumabNeed for pre-treatment vaccination
MRIPeriodically across most DMTs, and whenever relapse/progression is suspectedNew or enlarging lesions, PML changes, treatment response
Thyroid functionInterferons; ongoing for alemtuzumabThyroid dysfunction, autoimmune thyroid disease
Depression screeningOngoing on interferon therapyNew or worsening depression
Disability / relapse trackingEvery visit, over months to yearsExacerbations, hospitalizations, disease progression, disability scales such as the Expanded Disability Status Scale (EDSS)

Patient Counseling - What You'll Actually Say

  • Set expectations about the medicine's job:"This medication won't undo damage that's already happened, but it lowers your risk of new attacks and new damage going forward. Keep taking it even during a stretch where you feel completely fine."
  • Adherence is the whole game:"The biggest reason these medications stop working for people isn't that the drug fails, it's that people stop taking it. Tell me if side effects are making that hard before you just stop."
  • Flushing with fumarates:"Take this with food, it noticeably cuts down the flushing and warmth you might feel after a dose."
  • Injection site rotation:"Rotate your injection sites every time, thighs, abdomen, back of the arms, so you don't end up with a sore or damaged patch of skin in one spot."
  • Interferon flu-like symptoms:"You can take an over-the-counter pain reliever before or with your injection to blunt the flu-like achiness, and it usually gets better after the first few doses."
  • Vaccines:"Tell every provider you see that you're on this medication before you get any vaccine, some live vaccines aren't safe for you right now."
  • Pregnancy planning:"If you're thinking about becoming pregnant, we need to talk about this medication well before you try to conceive, don't just stop or continue on your own."
  • PML awareness on natalizumab or fumarates:"Call immediately if you notice new confusion, vision changes, weakness, or trouble speaking that's different from your usual MS symptoms. It might be nothing, but this is the one thing we don't wait on."
  • Bladder self-catheterization or medication:"Managing your bladder symptoms now is what prevents kidney stones and repeat infections down the road, it's worth being consistent about even when it's inconvenient."

High-Yield Recall Sheet

  • Relapse = new/worsening neuro symptoms lasting ≥24 hours.RRMS relapses remit; SPMS/PPMS progression does not.
  • Three treatment buckets:steroids for exacerbations, DMTs for the long-term course, symptomatic drugs for existing deficits. None substitute for another.
  • Methylprednisolone 500-1000 mg/day IV x 3 daysis first-line for a functionally significant relapse; starting within 2 weeks speeds recovery.
  • ACTH is the only FDA-approved agent specifically for exacerbationsbut is rarely used (cost/access).
  • Ocrelizumab is the only DMT approved for PPMS.
  • Mitoxantroneis approved for SPMS/worsening RRMS but avoided due to secondary AML risk and a 140 mg/m² lifetime cap.
  • JCV antibody status gates natalizumab use;an index above 0.9 raises PML risk substantially.
  • Siponimod requires CYP2C9 genotypingbefore the first dose; contraindicated in *3/*3.
  • S1P modulators (fingolimod, siponimod, ozanimod, ponesimod)all require cardiac screening/first-dose observation and VZV antibody checks.
  • Teriflunomide is pregnancy category X;cholestyramine/charcoal accelerates its elimination if needed.
  • Cladribineis dosed in a unique pulsed 2-year course, then nothing for 2 years; contraindicated in reproductive-age patients without contraception.
  • Alemtuzumabpremedicate with high-dose methylprednisolone x 3 days and give herpes prophylaxis for ≥2 months; watch for delayed secondary autoimmune disease (thyroid, ITP, Goodpasture).
  • Fumarates (dimethyl/diroximel/monomethyl):take with food to reduce flushing; watch lymphocytopenia, LFTs, rare PML.
  • Live vaccines are avoided on DMTs;flu shot yearly (injectable, not intranasal live).
  • Stop DMT before planned conception;discontinue on accidental pregnancy exposure unless disease risk outweighs drug risk.
  • Absence of relapses on a DMT is not proof to stop it;switching for suboptimal response means changing mechanism of action.
  • EDSSis the disability scale used to track therapeutic outcomes over months to years.
  • Diagnosis is exclusionary: needs ≥2 episodes of distinct CNS damage not explained by another disease, supported by MRI, CSF oligoclonal bands/IgG, evoked potentials, and OCT.