Algorithm of treatments for multiple sclerosis

Abstract

Multiple sclerosis (MS) often develops in the 20s and 30s, and has a major impact on later life for patients. Patients often suffered from relapses, and activities of daily living (ADL) of patients often declines as symptoms progress gradually from the early stage of the disease. In Japan, eight types of disease modifying drugs (DMDs) for MS have been marketed since 2000. The efficacy, side effects, and route of administration of each drug differ, and the appropriate DMD should be selected at the appropriate time, taking into consideration the patient's disease activity and poor prognostic factors, as well as recent life events and the patient's needs. The Guidelines for Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders have been revised as a benchmark for this purpose. This article discusses the treatment algorithm for MS, referring to the guidelines.