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Highly Effective Treatments with Good Risk/Benefit Ratios

Individualizing treatment according to a patient’s risk profile starting with high-efficacy treatments helps prevent irreversible brain and spinal cord damage, thus leading to better outcomes.

    • First Line: Natalizumab (Tysabri) in JCV negative patients, rituximab (Rituxan), ocrelizumab (Ocrevus) and ofatumumab (Kesimpta)
    • Second Line: Fingolimod (Gilenya), siponimod (Mayzent), ozanimod (Zeposia), dimethyl fumarate (Tecfidera), monomethyl fumarate (Vumerity)
    • Third Line: Teriflunomide (Aubagio), glatiramer acetate (Copaxone, Glatopa, generic GA), beta interferons (Avonex, Rebif, Betaseron, and others).
    • Fourth Line (only to be used in patients who have failed multiple other therapies): Natalizumab in JCV positive patients, alemtuzumab (Lemtrada), cladribine (Mavenclad), stem cell transplant (HSCT)

Source: Rocky Mountain MS Center Medical Director Dr. Timothy Vollmer


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