elapsing-remitting multiple sclerosis (RRMS) is the most common form of MS. About 85 percent of people with MS are first diagnosed with RRMS.
RRMS is one type of MS, which is a chronic and progressive condition of the central nervous system that interrupts the transfer of information between your brain and body. Your immune system attacks myelin, or the protective layer around nerves.
RRMS involves periods of remission, where you don’t experience any symptoms or progression. These occur between relapses of new or worse symptoms.
Treatment of RRMS is essential to help reduce the risk of new symptoms. It may also help reduce the number of MS relapses and the risk of the disease progressing into secondary-progressive MS (SPMS). In SPMS, symptoms get worse without periods of remission.
Researchers continue to explore new RRMS treatments.
Here’s what to know about these promising treatments as well as some of the clinical trials furthering our knowledge of this disease.
Current treatments for RRMS
Disease-modifying therapies (DMTs) are the main treatment for RRMS. They were first introduced in the early 1990s. New DMTs have steadily been introduced since then.
DMTs appear to reduce the number of MS attacks between 28 to 68 percent while reducing the number of brain and spinal cord lesions. These medications are also shown to help slow the progression of the disease.
As of 2020, the Food and Drug Administration (FDA) has approved more than a dozen DMTs to treat MS. These include injectable, intravenous, and oral medications.
DMTs appear to help manage RRMS in a number of ways. Some stop immune cells from damaging nerves in the brain and spinal cord. Others decrease the inflammation causing brain and spinal damage in MS.
Early intervention may prevent permanent damage to the central nervous system. Doctors recommend starting a DMT as soon as possible after you’re diagnosed with MS.
You’ll likely continue a DMT unless it’s not managing the disease properly or if the side effects it causes become intolerable. If you need to stop one DMT, your doctor will likely recommend another.
Side effects of DMTs may include but are not limited to:
- skin irritation at the site of injections
- flu-like symptoms
- nausea and upset stomach
- diarrhea
- changes in heart rate
- skin flushing
- reduced liver function
- increased risk of infections
None of these treatments are approved for women who are pregnant or breastfeeding. Be sure to tell your doctor if you’re planning to conceive, pregnant, or breastfeeding.
Upcoming RRMS treatments
New DMTs continue to come out for the treatment of RRMS. Two of the newest FDA-approved DMTs are the oral medications siponimod (Mayzent) and ozanimod (Zeposia).
Researchers continue to look into other ways to help reduce new lesions and relapses.
Cannabis (medical marijuana) and CBD (cannabidiol) have been studied as a possible treatment for symptoms of MS.
Some researchTrusted Source suggests these substances may help reduce pain, muscle spasms, and bladder spasticity linked to MS.
Cannabis has been linked to side effects, including psychosis in some people, cardiovascular diseases, and cannabinoid hyperemesis syndrome.
More evidence is needed before doctors can recommend either of these substances for people with RRMS.
Other potential areas of interest include:
- Lipoic acid. Lipoic acid is an antioxidant that affects the function of cell mitochondria. An ongoing clinical trial is exploring whether it may help with progressive brain atrophy.
- Vitamin D. ResearchTrusted Source has found that vitamin D may be protective against MS.
- Fecal microbial transplantation (FMT). FMT is an area of interest since some studies suggest people with MS have a different set of gut microbes. Ongoing research aims to discover if FMT can alter the gut microbiome.
- Stem cell therapy. Preliminary researchTrusted Source has found that stem cell therapy may help reduce relapses and disease progression.
The role of clinical trials
Clinical trials are medical studies in humans that look at whether a treatment is safe and effective for widespread use.
Any new medication or therapy must go through a series of clinical trials before the FDA approves it as a treatment for any health condition.
By participating in a clinical trial, you may benefit from a new treatment that’s more effective than existing options. You may also be exposed to unknown risks since the treatment hasn’t yet been widely used.
Some current clinical trials for MS are exploring:
- walking, strength training, and other mind-body activities for symptom management
- how dietary changes and the use of vitamins or supplements may reduce MS symptoms
- the efficacy, tolerance, and safety of existing DMTs
- whether taking hormones, such as estriol and testosterone, can protect against MS or reduce MS symptoms
- the role of genes and biomarkers in MS, to help with earlier diagnosis
Learn more about current clinical trials for MS from the:
The takeaway
DMTs reduce the number of relapses you experience and may slow the progression of MS. But there’s still no cure for MS and much to learn about this neurological disease.
Researchers are looking at the role of genes for new directions in diagnosis and treatment.
Scientists also continue to explore and develop new treatments to help reduce MS progression while increasing your quality of life.
Talk to your doctor about new and upcoming therapies for MS. They can discuss how these new measures could fit into your current treatment plan.
If you’re interested in participating in a clinical trial, discuss the potential benefits and risks with your healthcare provider.
