The Importance of Long-Term Treatment
Since the 1990s, the FDA-approved disease-modifying therapies (DMTs) were only available for individuals with relapsing forms of multiple sclerosis – largely for those with RRMS. However, in early 2017, a new medication, Ocrevus™ (ocrelizumab), was approved for both relapsing forms of MS as well as primary-progressive MS, which was very exciting news for the MS community. Research continues at a rigorous pace to find additional treatments aimed at treating all forms of MS. In addition, symptom-management strategies and comprehensive care plans with teams of doctors, nurses, and therapists, help to greatly improve the quality of life for all individuals with MS – both with relapsing and progressive forms of MS.
Treatment with a long-term DMT is crucial for most people with relapsing and now progressive forms of MS, since disease activity and damage usually continue within the CNS even when no new symptoms are present. When a patient begins a treatment regimen early in his or her disease course, disease activity is slowed for most individuals. This not only reduces the number and severity of symptom flare-ups, but also reduces the number of active lesions that appear on an MRI, as well as delays the progression of the disease (possibly delaying any related disability).
An ongoing study with more than 20 years of data demonstrates that individuals with RRMS who began therapy early in the disease found that they experienced a longer lifespan than those who did not begin treatment as early. This study was conducted with a specific DMT; more studies are needed to see if the same is true for all DMTs.
Getting early treatment and staying on a DMT for MS may also delay the rate of conversion from RRMS to secondary-progressive MS (SPMS). This latter form of MS that follows RRMS exhibits a steady worsening, with or without relapses. If flare-ups do occur, they usually do not remit fully. As mentioned earlier, without treatment, about half of individuals with RRMS convert to SPMS within 10 years. However, since the introduction of the first treatment in 1993, those taking a DMT have reduced or delayed the conversion to SPMS.