Multiple sclerosis (MS) is a chronic, immune-mediated, inflammatory disease affecting the white and gray matter of the central nervous system. Several disease modifying therapies (DMTs) have been shown to significantly reduce relapse rates, slow disability worsening, and modify the overall disease course of MS. Decision-making when initiating a DMT should be shared between the patient and physician. Important factors such as prognostic indicators, safety, patient preferences, adherence, and convenience should also be considered. Treatment guidelines recommend switching a DMT when a patient experiences breakthrough disease activity, but also for patients who experience adverse events. Compared with injectable therapies, oral DMTs are often associated with increased treatment adherence and patient satisfaction, due to a less burdensome route of administration and greater tolerability. This review will summarize the available scientific evidence for injectable DMTs and the oral DMT teriflunomide, including considerations for both treatment-naïve patients initiating a DMT and patients switching from an injectable DMT.
Keywords: Disease modifying therapies; Injectable DMTs; Multiple sclerosis; Switching; Teriflunomide.
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.