Welcome to the MSAA Ultimate MS Treatment Guide

The MSAA Treatment Guide compares 19 different FDA-approved MS treatments. This powerful tool includes medical and patient experts discussing their first-hand experience, so you can make an informed choice that is right for you.

Select Up to Three to Compare

Sort By:
SHOW RESULTS
Filter By:
SHOW RESULTS
Opting Out of Treatment

Taking control of MS is a different path for everyone. Learn more about the choice to opt-out of treatment from Dr. Hendin.

See what it means to opt out
Treatment Philosophy

Escalation or Early Highly Effective (EHE) therapy: Learn why your doctor is recommending one of these treatment courses.

Learn More
teriflunomide
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Increase in liver enzymes
  • Nausea and diarrhea
  • Hair thinning

Less common, but serious side effects (for full details see individual therapy entries)

  • Inflammation of the liver which can cause liver failure (rare). Monitored by blood work monthly for the first 6 months.

Learn about Aubagio® with MS Neurologist Dr. Kyle Smoot

Interferon beta-1a
ISelf-injected medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Flu-like symptoms
  • Upper respiratory infection
  • White Blood Count and liver test abnormalities

Less common, but serious side effects (for full details see individual therapy entries)

  • Heart failure
  • White Blood Count problems
  • Thyroid problem
  • Seizures
  • Liver damage

Learn about Avonex with MS Neurologist Dr. Derrick Robertson.

monomethyl fumarate
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Flushing and stomach problems, especially at the start of therapy, and may decrease over time
  • Redness, itching, rash
  • Diarrhea

Less common, but serious side effects (for full details see individual therapy entries)

  • Allergic reactions
  • PML (progressive multifocal leukoencephalopathy)
  • Serious infections
  • Liver injury

Learn about Bafiertam with MS Neurologist Dr. Augusto Miravalle.

Interferon beta-1b
ISelf-injected medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Flu-like symptoms
  • Injection-site skin reaction
  • White Blood Count and liver test abnormalities

Less common, but serious side effects (for full details see individual therapy entries)

  • Liver abnormalities
  • Heart problems and hypertension
  • Kidney problems

Learn about Betaseron® with MS Neurologist Dr. Annette Howard.

glatiramer acetate
ISelf-injected medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Nausea
  • Injection site reactions
  • Lipoatrophy (injection site indentations in the skin)

Less common, but serious side effects (for full details see individual therapy entries)

  • Immediate post-injection reaction
  • Liver problems

Learn about Copaxone® with MS Neurologist Dr. Andrew H. Woo

fingolimod, FTY720
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Liver function test abnormalities
  • High blood pressure
  • Respiratory infections

Less common, but serious side effects (for full details see individual therapy entries)

  • Serious infections including progressive multifocal leukoencephalopathy (PML), fungal (cryptococcal meningitis) and malignancies including skin cancer and lymphoma
  • Risk of serious rebound MS disease activity if stopped

Learn about Gilenya® with MS Neurologist Dr. Barry A. Singer

ofatumumab
ISelf-injected medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Headache and upper respiratory tract infection (URTI), including sore throat, runny nose
  • Injection-related reactions (fever, headache, muscle pain, chills, and fatigue)
  • Local injection site reactions (redness, pain, itching, and swelling)

Less common, but serious side effects (for full details see individual therapy entries)

  • Infections: hepatitis B or hepatitis C viruses reactivation
  • Progressive multifocal leukoencephalopathy (PML)
  • Weakened immune system

Learn about Kesimpta® with MS Neurologist Dr. Erica M. Rivas-Rodriguez

alemtuzumab
Infused medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Infusion site reactions
  • Increased risk of Infection
  • Over-or-underactive thyroid

Less common, but serious side effects (for full details see individual therapy entries)

  • Emergent autoimmune diseases
  • Idiopathic thrombocytopenic purpura (ITP, a potentially severe bleeding disorder)
  • Increased risk of malignancies including thyroid cancer, melanoma and lymphoproliferative disorders

Learn about Lemtrada® with Nurse Practitioner Megan Weigel, DNP

cladribine
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Upper respiratory tract infections
  • Headache
  • Decreased lymphocyte counts

Less common, but serious side effects (for full details see individual therapy entries)

  • Lymphopenia
  • Herpes zoster infection
  • Risk of malignancy (cancer)
  • Tuberculosis
  • Progressive multifocal leukoencephalopathy (PML)

Learn about Mavenclad® with MS Neurologist Dr. Barry A. Hendin

siponimod
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Headache
  • High blood pressure
  • Changes in liver function

Less common, but serious side effects (for full details see individual therapy entries)

  • Decrease in white blood cells (increase risk of infection)
  • Decrease heart rate and rhythm abnormalities
  • Swelling of the macula of the eye
  • Varicella zoster reactivation (virus that causes shingles)
  • Hypertension
  • Convulsions

Learn about Mayzent with MS Neurologist Dr. Annette Okai

mitoxantrone
Infused medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Nausea
  • Alopecia (hair thinning)
  • Stomatitis (mouth irritation)

Less common, but serious side effects (for full details see individual therapy entries)

  • Heart failure: Systolic dysfunction
  • Acute promyelocytic leukemia
  • Amenorrhea (absence of menstruation)

Learn about Novantrone® with MS Neurologist Dr. James Bowen

ocrelizumab
Infused medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Infusion related reactions
  • Chest, gastrointestinal and skin infections
  • Viral infections including herpes

Less common, but serious side effects (for full details see individual therapy entries)

  • Cancer
  • Progressive multifocal leukoencephalopathy (PML)

Learn about Ocrevus with MS Neurologist Dr. Elizabeth Crabtree

peginterferon beta-1a
ISelf-injected medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Flu-like symptoms
  • Injection-site skin reaction
  • White Blood Count and liver test abnormalities

Less common, but serious side effects (for full details see individual therapy entries)

  • Liver failure. Blood tests can monitor liver enzymes
  • Depression

Learn about Plegridy® with MS Neurologist Dr. Jeffrey English

ponesimod
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Upper respiratory tract infections
  • Elevated liver enzymes
  • High blood pressure

Less common, but serious side effects (for full details see individual therapy entries)

  • Serious infections
  • Slowed heart rate (bradycardia or bradyarrhythmia)
  • Skin cancer

Learn about Ponvory with MS Neurologist Dr. Regina Berkovich

Interferon beta-1a
ISelf-injected medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Flu-like symptoms
  • Injection-site skin reaction
  • White Blood Count and liver test abnormalities

Less common, but serious side effects (for full details see individual therapy entries)

  • Seizures
  • Liver problems, including liver failure
  • Can affect bone marrow causing low red and white blood cell and platelet counts
  • Depression and suicidal thoughts

Learn about Rebif® with MS Neurologist Dr. Lori Hendin Travis

dimethyl fumarate
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Flushing
  • Pruritus (chronic itching)
  • Erythema (skin redness or rash).
  • Gastrointestinal upset, diarrhea, and nausea

Less common, but serious side effects (for full details see individual therapy entries)

  • Decrease in white blood cells (lymphopenia)
  • Increased liver function enzymes
  • Progressive multifocal leukoencephalopathy (PML)

Learn about Tecfidera® with MS Neurologist Dr. Carrie M. Hersh

natalizumab
Infused medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Headache and fatigue
  • Infections like upper respiratory tract infection or urinary tract infection (UTI)
  • Infusion reactions

Less common, but serious side effects (for full details see individual therapy entries)

  • Risk of serious infection, including pneumonia
  • Progressive multifocal leukoencephalopathy (PML)

Learn about Tysabri® with MS Neurologist Dr. Heidi Crayton

diroximel fumarate
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual therapy entries)

  • Flushing
  • Stomach problems
  • Redness, itching, rash

Less common, but serious side effects (for full details see individual therapy entries)

  • Progressive multifocal leukoencephalopathy (PML)
  • Central nervous system infections
  • Decreased white blood cell count
  • Liver problems

Learn about Vumerity® with MS Neurologist Dr. Mitzi Joi Williams

ozanimod
Oral medication

Common side effects affecting more than 1 person in 100 (for full details see individual drug entries)

  • Infection
  • Liver enzyme elevation
  • Short-term Bradycardia (slow heart rate)

Less common, but serious side effects (for full details see individual drug entries)

  • Progressive multifocal leukoencephalopathy (PML)
  • PRES Syndrome
  • Macular edema
  • Rebound after stopping

Learn about Zeposia® with MS Neurologist Dr. Léorah Freeman


MSAA would like to thank the healthcare professionals and patient advocates, as well as our Healthcare Advisory Council, who participated in the creation of the Ultimate MS Treatment Guide and played an essential role in guiding its content.

The information in the Ultimate MS Treatment Guide does not constitute medical advice and is for informational purposes only.
As with all treatment decisions, you are urged to consult your physician.

The MSAA Ultimate MS Treatment Guide has been made possible through generous support from the following:

Janssen/J&J logo


Biogen
Bristol Meyers Squibb
EMD Serono
Genentech
Novartis
Sanofi