The Evolving Landscape of MS Treatment: What Patients Should Know

Multiple sclerosis (MS) treatment has transformed dramatically over the past three decades. What once involved limited options and frequent relapses has evolved into a field filled with highly effective therapies, personalized care strategies, and promising innovations on the horizon. 

In the latest episode of Elliot Health Talks, Dr. Ann Cabot, neurologist at Elliot Health System, breaks down today’s MS treatment landscape, from disease‑modifying therapies to emerging research that could shape the future of care. 

How MS Treatment Has Changed Over Time 

Dr. Cabot notes that the first FDA‑approved MS therapies didn’t arrive until 1993. These early injectable medications helped slow disease activity but required frequent dosing and came with side effects and monitoring needs. 

Since then, treatment options have expanded dramatically. Today, patients have access to more than 20 therapies across multiple categories, injectables, oral medications, and infusions, each designed to reduce relapses, prevent new lesions, and slow long‑term progression. 

This progress has reshaped what it means to live with MS, offering patients more control and more hope than ever before. 

Understanding Disease‑Modifying Therapies (DMTs) 

Disease‑modifying therapies are the cornerstone of MS treatment. Their goal is simple but powerful: reduce inflammation, prevent new lesions, and slow the disease from progressing. 

Dr. Cabot explains that while MS is a lifelong autoimmune condition with no cure, DMTs help “calm down” the immune system, so it stops attacking the central nervous system. Different therapies work in different ways, which is why choosing the right one is a highly individualized process. 

How Providers Monitor Treatment Effectiveness 

Tracking whether a therapy is working involves several key steps: 

• Monitoring symptoms such as new numbness, weakness, vision changes, or bladder/bowel issues 

• Routine MRI scans to detect silent disease activity that patients may not feel 

• Regular office visits to assess neurological function and adjust treatment as needed 

Even when patients feel well, imaging can reveal subtle changes, making ongoing monitoring essential for long‑term success. 

Can MS Go into Remission? 

For many patients with relapsing‑remitting MS, the most common form, treatment can significantly reduce or even eliminate relapses. In these cases, patients may experience long periods of remission. 

However, MS remains unpredictable. Some individuals may go for years between relapses, while others experience more frequent activity. This variability underscores the importance of early treatment and consistent follow‑up. 

Dr. Cabot also highlights how aging, infections, and other medical conditions influence treatment decisions over time. As patients’ health changes, their therapy may need to change with it. 

Today’s Treatment Options — and What’s Coming Next 

Current therapies include: 

• Injectables such as interferons and glatiramer acetate 

• Oral medications including sphingosine modulators, fumarates, and teriflunomide 

• Infusion therapies, including highly effective B‑cell therapies 

• Reconstitution therapies like Mavenclad 

B‑cell therapies have been a breakthrough, offering high efficacy with manageable monitoring requirements. 

Looking ahead, Dr. Cabot is especially encouraged by BTK inhibitors, a new class of medications currently under investigation. These therapies may help address one of the biggest unmet needs in MS care: slowing progression in patients who are no longer experiencing relapses. 

Learn More 

For more information about neurological services and MS care at Elliot Health System, visit ElliotHospital.org/MS. 

And don’t forget — you can listen to the full conversation with Dr. Cabot here.