Multiple sclerosis: current treatment algorithms

Purpose of review:Multiple sclerosis (MS) is an inflammatory autoimmune disorder of the central nervous system. Currently, there are different formulations approved for MS treatment and others are in different stages of investigation or awaiting approval by federal agencies.

Recent findings:All of these medications have demonstrated partial efficacy along with different side-effect profiles. Nevertheless, many patients continue to experience disease activity while on treatment, and recommendations have been made on how the success of therapy in an individual patient can be assessed.

Summary:The option of individualized optimal treatment is progressively more complicated due to the growth of our knowledge about the natural behavior of MS and its different types and stages, the variety of different therapies, their strength and weaknesses, and their serious and sometimes life-threatening side-effects. In this review, we will summarize current algorithms and treatment options and also address clinical challenges we regularly face in arriving at treatment choices for our patients.