Multiple sclerosis therapy – state of the art

While there has been considerable progress in the treatment of relapsing-remitting multiple sclerosis (MS), no disease-modifying therapy is available for primary progressive MS. For the relapsing-remitting form, a broad spectre of immunomodulatory treatments is available. Along with classic interferon-ß and glatiramer acetate, teriflunomide and dimethyl fumarate are first choice in mild to moderate MS. In highly active MS, alemtuzumab, natalizumab and the oral medication fingolimod may be considered. Complementary, alternative therapies may be used in all forms of MS. There are, however, some contraindications. Acupuncture is not useful when acute inflammation or chronic spasticity is present.