The evolution of MS care

Today there are a wide range of treatments available to help control relapses in multiple sclerosis (MS) and to reduce disease progression for many people. These are called disease-modifying therapies (DMTs). As the science of MS continues to evolve, the history and future of MS care is important to understand.

Historically

In the past, MS care was focused on targeting and controlling relapse activity. Then, magnetic resonance imaging (MRI) changed how we monitor disease activity in MS. This diagnostic test is one of the most useful tools to see the impact of lesions on the brain and spinal cord over time.

Now

While MS treatment has come a long way, there’s still more to address. Relapses and MRI activity have been the focus of clinical trials in the past. Today, the focus in MS is shifting to ways of managing and detecting disability progression, despite no relapses or MRI activity.

As MS changes over time, you may find it impacting everyday tasks. When you start to notice changes in your MS, you can start to do something about it. Here are a few things you could try to help deal with cognitive and physical challenges:

• Rehab led by a speech, occupational, and/or physical therapist
• Therapy, meditation, mindfulness, and/or other mental health practices
• A healthy diet and regular exercise
• Support groups that connect you to others with MS

Lifestyle changes and types of rehabilitation are important ways of managing progressing MS, in addition to treatment. There are now many different treatment options available to choose from.

MS treatments of tomorrow

Unfortunately, not all people with MS respond well to the MS therapies available now. Up to 65% of people living with MS report experiencing progression independent of relapse activity (PIRA). This means that, even if they are no longer experiencing relapses or MRI activity, patients continue to experience disability over time. Currently, therapies have not yet been able to show an impact on slowing PIRA.

There's research happening right now that could change the future of MS. Research has identified that microglia and B cells within the central nervous 
system (CNS)The part of your nervous system that includes the brain and spinal cord. may be driving disability progression in people living with MS, and targeting these cells may help slow disability. One way to do this is through targeting an enzyme that activates these cells, known as Bruton's Tyrosine Kinase (BTK). This new focus of MS science could expand future treatment options to manage both physical and cognitive changes that lead to disability progression.

What's next?

Thanks to advances in research, a new understanding of MS is within reach. Just as scientists are evolving how they think about MS, you can always evolve your goals and lifestyle to meet your changing needs, too. If you're noticing changes in the way you do things because of your MS, consider talking to your healthcare provider about ways of managing them.