Treatment Options

1. Change Medications

Switching between classes of medications such as Interferons and Copaxone might be helpful. Since randomized head-to-head trials showed some benefit of Rebif and Betaseron over Avonex on relapses and MRI activity, switching from Avonex to Betaseron or Rebif might be useful. Tysabri and Novantrone are definite options for worsening relapsing remitting disease, but carry increased risks.

2. Add Another Treatment

Less scientific data supports this option, but it is something to consider with your health care provider. Many MS specialists have used various oral medications in addition to interferons and Copaxone such as azathioprine, cyclophosphamide, and methotrexate. Intravenous steroids for 1-2 days monthly called pulse steroids are sometimes used.

3. Enter a Clinical Trial

When running out of treatment options due to worsening disease or tolerability problems with current medications, a clinical trial may be an option. Some clinical trials allow access to promising new medications that are still being studied and not FDA-approved. If your disease is worsening, enrollment in trial with a chance you could be on no treatment (placebo) would most likely be not advisable unless you have no other options. Some trials allow all patients to be on medication. The unknown and known risks of an experimental medication must be carefully considered before enrolling in a clinical trial.