Three-step therapy model
Multiple sclerosis is at present not curable. Neurologists have provided a three-step therapy model, taking the specific disease course into consideration:
- therapy of the acute attack
- disease-modifying treatment
- symptomatic therapy
Therapy of the acute attack
For treatment of acute attacks physicians use cortisone medications. Cortisone is anti-inflammatory and has a positive influence on the rapid remission of symptoms. It is usually applied intravenously, i.e. per infusion. If the desired effects are not achieved, a disabling acute attack can also be treated by plasmapheresis (plasma exchange).
Various so-called disease-modifying drugs are used for the treatment of MS. As a therapy for mild/moderate disease courses, interferone-beta, glatiramer acetate, teriflunomid or dimethyl fumarate are usually prescribed. These drugs can prevent attacks and most likely also have a positive long-term effect on the disease course. Other drugs such as natalizumab, fingolimod, alemtuzumab or mitoxantrone affect the immune system on a deeper level and thus can have severe, sometimes even life-threatening side effects. They are therefore in general only approved for therapy of MS in active disease courses.
Due to the diversity of symptoms in MS there are many other therapeutic measures which are used when needed: physiotherapy, occupational therapy, speech therapy or psychotherapy. Additional medication for specific symptoms such as bladder problems or depression may also be necessary.