Background and purpose: There is still no curative treatment for multiple sclerosis (MS), but during the last 20 years eight different disease-modifying compounds have been approved for relapsing-remitting MS (RRMS).
Methods: A literature search was conducted on published randomized controlled phase III trials indexed in PubMed on the approved medications until 21 May 2015.
Results: In this review the mode of action, documented treatment effects and side effects of the approved MS therapies are briefly discussed.
Conclusions: Based on current knowledge of risk-benefit of the approved MS medications, including factors influencing adherence, it is suggested that oral treatment with dimethyl fumarate or teriflunomide should be preferred as a starting therapy amongst the first-line preparations for de novo RRMS. In the case of breakthrough disease on first-line therapy, or rapidly evolving severe RRMS, second-line therapy with natalizumab, fingolimod or alemtuzumab should be chosen based on careful risk-benefit stratification.
Keywords: disease-modifying; multiple sclerosis; review; treatment.
© 2015 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.