Disease-modifying treatments for multiple sclerosis - a review of approved medications

Eur J Neurol. 2016 Jan;23 Suppl 1(Suppl 1):18-27. doi: 10.1111/ene.12883.


Background and purpose: There is still no curative treatment for multiple sclerosis (MS), but during the last 20 years eight different disease-modifying compounds have been approved for relapsing-remitting MS (RRMS).

Methods: A literature search was conducted on published randomized controlled phase III trials indexed in PubMed on the approved medications until 21 May 2015.

Results: In this review the mode of action, documented treatment effects and side effects of the approved MS therapies are briefly discussed.

Conclusions: Based on current knowledge of risk-benefit of the approved MS medications, including factors influencing adherence, it is suggested that oral treatment with dimethyl fumarate or teriflunomide should be preferred as a starting therapy amongst the first-line preparations for de novo RRMS. In the case of breakthrough disease on first-line therapy, or rapidly evolving severe RRMS, second-line therapy with natalizumab, fingolimod or alemtuzumab should be chosen based on careful risk-benefit stratification.

Keywords: disease-modifying; multiple sclerosis; review; treatment.

Publication types

  • Review

MeSH terms

  • Clinical Trials, Phase III as Topic*
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects
  • Immunologic Factors / pharmacology*
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Randomized Controlled Trials as Topic*


  • Immunologic Factors