ARTICLEMS

7 Advances in MS Treatment and Care Worth Celebrating

By Lisa M. Basile

Reviewed by Dana Cooper, M.D.

June 02, 2022

If you’re living with multiple sclerosis (MS), you probably know that the disease can be challenging to manage—to say the least. There’s no cure for this immune-mediated, inflammatory disease of the central nervous system (yet), but recent advances in MS treatment and care show there’s a lot to be hopeful about. From effective new medications approved by the Food and Drug Administration to a deeper focus on you, the individual, science is paving the way toward better MS care.

New Therapy Options

In the last two decades alone, several FDA-approved disease-modifying therapies (DMTs) have been made available to people with MS, leading to a better prognosis and quality of life for many, says Barbara Giesser, M.D., a board-certified neurologist and MS specialist at Pacific Neuroscience Institute at the Providence Saint John’s Health Center in Santa Monica, California.

Giesser says that some of the most promising recent therapies include B cell therapy (also known as B cell depletion therapy), a type of treatment that targets the B cells responsible for damaging nerves in the brain and spinal cord. This treatment can be effective in treating relapsing and progressive forms of MS and is rooted in a newer understanding of how people develop the disease (known by doctors as its pathogenesis).

According to a 2022 article published in the journal Cureus, only recently have studies shown that B cells are involved in the development of MS. Before that, it was considered to be mainly mediated by T cells.

Immune reconstitution therapy (IRT) is another newer advance in MS treatment worth noting. “[IRTs] depopulate the immune cells temporarily, and then when they come back, they don’t attack the body,” Giesser says. This allows the immune system to rebuild itself and respond to infections as it should, explains an article published in Immunologic Research. Some people who’ve been treated with IRTs have experienced remission from MS for more than 10 years, the article says.

Although these newer medical treatments are promising, Giesser emphasizes that there are many approved treatments available to people with MS, and that not everyone will have the same experience with every treatment plan. In short, treating the disease is a very individual experience.

Rethinking the Initial Treatment Approach

Beyond the treatments themselves, the approach doctors take in treating multiple sclerosis may be changing, as well. Giesser explains that, over the years, doctors have been seeking answers about the best way to begin treatment. “The question is, [for the] newly diagnosed, Do you pick a safer but less effective therapy, or do you hit people with more effective therapies from the get-go?”

The good news, she says, is that there are currently two clinical trials in place—TREAT-MS and DELIVER-MS—trying to answer that question.

Currently, Giesser says, doctors typically escalate medicine, or start with the less effective treatments first. However, she says, “Some small trials say more effective from the get-go is better.” While the better approach isn’t entirely clear yet, researchers are getting closer to knowing how best to tackle MS from the start thanks to those larger-scale trials.

Finding the Connection Between MS and Epstein-Barr Virus

New research has found a clear link between multiple sclerosis and Epstein-Barr virus (EBV), a common virus that causes mononucleosis (mono) or other illness and can present with cold- or flu-like symptoms.

A long-term study conducted on 10 million young adults in the military found that people who had previous EBV infection were 32 times more likely to develop MS.

“There’s always been a theory or some evidence that EBV is a trigger to MS, but recent studies are confirmatory,” explains Martin I. Belkin, D.O., a board-certified neurologist at the Michigan Institute for Neurological Disorders (MIND). “That will hopefully lead to vaccination [for EBV] or a more specific treatment targeting cells that are infected with EBV.”

Greater Focus on Precision Medicine

Precision medicine—medical care tailored to a person’s unique genetics, lifestyle, and environment—is being used to look at how best to treat MS. This advance may help doctors decide which DMT (since there are a lot of options) might be right for each individual.

“This is a new area in neurology—or more specifically in MS. It still has a ways to go, but it’s an unmet need,” Belkin says. The goal, he says, is for precision medicine to help doctors answer these questions and to treat the individual rather than relying on large pools of data.

Deeper Understanding of Cognition

Many people with MS find that the disease affects their cognition, experiencing “cog fog,” an impairment of memory, concentration, and/or thinking. And in the last decade, doctors have been focusing closely on the link between cognition and MS.

So what does this mean for people with MS? For one, it’s validating. Second, early recognition of these problems can help prevent the effects of impaired cognition, such as losing employment or income potential, Belkin says.

“Clinics are now routinely screening for cognitive dysfunction,” Belkin says. “We want to preserve cognition.” According to the National Multiple Sclerosis Society (NMSS), cognitive rehabilitation can help people improve their cognition and/or find ways to compensate for impairments. More studies are being done to help identify other ways to preserve cognition, too.

Additional Support and Community

“We encourage people with MS to seek counseling and community resources,” Giesser says. With an explosion of apps, patient advocacy sites, and online resources available to people with MS, they can seek support simply by using their phone or computer.

For example, the NMSS offers several ways to connect with others, including:

MS Navigators: These trained professionals can give you the information and resources you’re looking for, plus personalized recommendations for finding support.
Local support groups: Meet other people in your area to create social connections and share your stories and successes.
MSFriends: If you’d benefit from a one-on-one, confidential conversation, the NMSS can connect you with someone, and you can even call its help line seven days a week from 9 a.m. to 12 a.m. ET at 866-673-7436 (866-MSFRIEND).

Facebook groups and Instagram hashtags are additional ways to connect to others with MS, as are online communities like ours.

Patient-Focused Care

In the last five years, Belkin says, a significant advance in MS treatment has been that doctors have taken a more patient-focused approach to care. But what does this mean, exactly? Instead of simply treating the disease with medication and hoping for improvement, Belkin says that “there is more focus on patient-reported outcomes and how the patient feels they are doing.”

What’s more, doctors are acting more holistically, he says—linking patients to support for nutrition, exercise, and mental health.

In the end, advances in MS treatment and care are paving the way for a more hopeful future. “For someone diagnosed with MS today, in general, our outlook for them is very positive,” Belkin says.

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