Most people who have multiple sclerosis (MS) are first diagnosed with a type called relapsing-remitting MS (RRMS), marked by defined episodes of increased nervous system symptoms and impairment followed by periods of remission. Currently, nearly all people who have RRMS are treated with a class of drugs called disease-modifying therapies (DMTs). DMTs help reduce relapses, delay the progression of MS, and prevent future nerve damage, but they don’t improve existing damage or alleviate symptoms.

There are now over two dozen DMTs used to treat MS, so there are a lot of options to choose from. “There is no one best disease-modifying therapy for everyone,” says Barbara Giesser, MD, a neurologist and MS specialist at the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California. “Choosing a DMT is a very nuanced conversation between the patient and the neurologist. You have to consider a number of factors.” This includes how aggressive your MS is and any other health conditions you have, as well as your lifestyle and personal preferences. DMTs can be administered by mouth, injection, or intravenous (IV) infusion.

Unlike, say, a headache medication that provides immediate relief, DMTs can take many months to start working. “These treatments don’t make people feel better, and they don’t treat symptoms,” Dr. Giesser says. Instead, DMTs are designed to lessen the immune system’s attack on the nervous system, which can help decrease the number of flares you experience and their severity.

The effectiveness of a DMT is primarily assessed by how well it reduces flares and whether your doctor can see new or inflamed lesions on magnetic resonance imaging (MRI). Most people with MS require therapy with a DMT along with other medications or strategies to help manage symptoms.

But you probably won’t be on the same DMT forever. There are many reasons you might eventually change to a different treatment, and switching is common.

Answer these questions find out if your treatment plan is as effective as it could be — and what you can do if it isn’t.

This assessment is part of a series aimed at helping you check in on your MS before your next checkup with your doctor. Take more assessments.

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