Comparison of first-line therapies for relapsing-remitting multiple sclerosis
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Multiple Sclerosis (MS) is a chronic and potentially disabling disease of the central nervous system (CNS) in which the immune system attacks the protective myelin layer that surrounds nerve cells. While the majority of individuals diagnosed with MS initially present with a non-progressive relapsing form of the disease, there is significant risk of eventually transitioning to a more progressive form for which there are few effective treatments. Consequently, early intervention with disease-modifying therapies (DMTs) is essential for effective disease management. Newly diagnosed patients are typically started on one of four first-line therapies (beta interferon, glatiramer acetate, teriflunomide, or dimethyl fumarate). Though there are distinct differences between these treatments in regard to efficacy and safety, there is no uniform standard for making decisions about which to initiate treatment with. This review gives an overview of current first-line MS therapies, and seeks to highlight the lack of comparison data and the gaps in the current understanding of disease management, as well as the need for more comprehensive research in these areas.