Why early treatment is important
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Although there is currently no cure for MS, modern therapies (known as disease-modifying therapies, or DMTs) can significantly alter the course of the disease: reducing the number of relapses, decreasing inflammation in the brain and spinal cord, and slowing the progression of disability. All current international protocols begin with this phrase: “The earlier treatment starts, the better the outcome.”

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Main types of therapy
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MS therapy usually includes the following components:

Disease-modifying therapy (DMT) — medications that affect the immune system, reduce inflammation, and interfere with the nervous system. 

Symptomatic treatment — remedies that relieve specific symptoms (e.g., muscle spasms, pain, fatigue).

Rehabilitation, physical therapy, and therapeutic exercise — help maintain function and improve quality of life. 

Supportive care and monitoring — monitoring tests, visits to a neurologist, monitoring side effects of therapy.

DMT categories and how they are administered
 

DMTs are divided by method of administration:
 

Oral medications — tablets or capsules that the patient takes on their own.

Injectable medications — subcutaneous or intramuscular injections, often administered by the patient or a nurse.

Infusion medications — administered intravenously in a hospital or clinic, less common but usually more “powerful.”
 

Each form has its advantages/disadvantages: convenience, frequency of administration, side effect profile.

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How is therapy chosen?
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The choice of a specific drug depends on:

• Type of MS (relapsing-remitting, primary progressive, secondary progressive) 

• Disease activity (number of exacerbations, MRI signs)

• The patient's health status, comorbidities

• Pregnancy planning

• Side effects, possibility of monitoring control

• Availability of the drug and supply program

What you need to know about side effects and monitoring?
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Almost all DMTs require regular monitoring: blood tests, liver function tests, heart monitoring, infection status, vaccinations. For example, some medications require an ECG at the first dose; others require HBV screening; still others require lymphocyte monitoring during treatment.

It is important for patients to:
 

• know which tests are important;

• adhere to the administration/dosage schedule;

• inform their neurologist of any new symptoms or changes;

• not stop therapy suddenly without consulting their doctor.

What patients can do on their own
 

Keep track of and record dosages and dates of administration/intake of the drug.

Monitor side effects and inform the doctor in a timely manner.

Ensure regular visits to the neurologist and examinations.

Follow recommendations for physical therapy, an active lifestyle, and a balanced diet.

Maintain open communication with your doctor: plan for pregnancy, changes in therapy, and respond to new information.

Expectations from therapy
 

It is important to have realistic expectations: therapy does not promise a complete cure, but it significantly improves the chances of living a full and active life. 
 

The goal is a good quality of life with MS, with minimal exacerbations, maximum functionality, and a planned future.

When to change therapy
 

Sometimes the chosen therapy may not be effective enough or may cause unacceptable side effects. The doctor and patient can discuss:

switching to a more “powerful” drug;

changing the route of administration;

temporary discontinuation by agreement (only under supervision).
It is important that the decision is made with the participation of a neurologist, taking into account the medical history and monitoring.

Additional options
 

For patients in whom standard therapy does not work, or who have an aggressive form of MS, special methods are considered, such as hematopoietic stem cell transplantation (aHSCT). However, such methods are experimental or specialized programs and require careful selection.

MS therapy is a complex task that includes not only medication but also regular monitoring, a healthy lifestyle, and adaptation to changes.
Your active participation is important: adherence to treatment, tests, communication with your doctor — all of this increases the chances of success.
“The earlier you start and the more regularly you adhere to the treatment, the more control you can gain over the disease.”