None of the disease-modifying drugs is recommended for women who are pregnant or plan to be. Risks are weighed against the benefits of the new treatments. We recommend newly diagnosed patients with evidence of definite multiple sclerosis (MS) start either Copaxone, Betaseron, Avonex, or Rebif right away to prevent further attacks and new magnetic resonance imaging (MRI) lesions. This is true also for cases of relapsing-remitting MS in whom attacks are still occurring. Those with deteriorating relapsing-remitting MS not responding to the above agents and those with secondary-progressive disease that is relentlessly worsening should consider Novantrone or Tysabri, in spite of the dangers of these drugs.
We also recommend that people whose disease has been stable for several years - with no attacks and no worsening - can skip this round of treatments and assess the next round of breakthroughs. In the meantime, just follow our suggestions of how to stay in top physical and emotional form.
For the rest, disease-modifying drugs are seen as an investment in the future. Unfortunately, none of the currently available drugs is approved for those with a primary-progressive course. In those cases, the greatest successes in treatment have been the tackling of individual symptoms. With rare exception, every symptom of MS can be treated, and every single patient improved.
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