Trevis格里森他首先被诊断出患有多发性硬化症（MS）在2001年的一天一个清晰的记忆他的医生送他回家的信息，改变疾病的治疗（也称为DMTS，疾病缓解治疗，或病了巨大的粘合剂-modifying药物）。
DMTS是全面照顾MS的重要组成部分，而且他们目前可用减慢疾病的自然病程的最佳选择，根据National Multiple Sclerosis Society。
回到格里森，现在53，被确诊的时候，只有三个DMTS可用来治疗MS。他被告知在所有阅读提供的信息，并选择他想成为的一个。通过材料会非常耗时和混乱，因为许多药物带着潜在的严重的副作用，从流感样症状发展心脏或肝脏疾病的风险。最终，格里森，谁分裂他的爱尔兰和西雅图之间的时间，决定了他最好的选择是一种干扰素β-1b治疗（更详细的介绍一些）。
While it’s been nearly two decades since Gleason’s experience, many MS patients can still relate to the plight of deciding which DMT is best for them. And now, instead of three options, there are 17 approved by the U.S. Food and Drug Administration (FDA). Which is great...but also a little dizzying.
The MS community has seen many advancements in the last 10 years, says Eoin Flanagan, M.B., B.Ch., a neurologist with the Mayo Clinic who specializes in MS. “We’re doing better in terms of having a lot more choices available, but that can make it difficult to navigate the lineup of so many different medications,” he says.
That’s where this guide can help.
The Goal of DMTs
重要的是要知道，DMTS并不意味着对待当前的MS症状（如乏力或麻木）是很重要的。相反，我们的目标是降低你经历缓慢的中枢神经系统病变的积累复发的总体数量，弗拉纳根博士解释说。
While using DMTs can’t “fix” the damage MS has already done, these medications are meant to help prevent or limit damage in the future, adds Kathy Costello, M.S., C.R.N.P., associate vice president of healthcare access with the国家社会女士。
“It’s like taking out an insurance policy,” Costello says. “You want to give yourself the best chance of living your best life with MS.”
But before you pick your “policy,” there are many things to consider, including potential side effects. That’s why it’s so important to play an active role in deciding which DMT is right for you, Costello says.
“If you’renewly diagnosed with MS不仅是本病的品牌新的给你，但现在你面对一个决定关于是一个非常强大的药物，可能为你的余生，”她说。“艾滋病患者需要的人去思考自己的目标，他们的风险承受能力。他们需要做的功课了解这些疗法，使他们能够与他们的医生真正的对话。”
有科斯特洛鼓励人们考虑与他们的医疗保健提供者讨论两个主要问题：
- What should I expect from the disease-modifying therapy?
- 什么副作用，我该怎么办呢？
It may take multiple conversations with your doctor before you make a decision—and that’s fine. Together you’ll decide on the treatment that’s best for you. Each person’s body or disease can respond to these medications differently, plus a medication that adequately controls your disease today may not do so in the future.
好消息是：你有选择。下面是你应该了解的主要类型DMTS什么。
First-Generation Injectable Treatments for MS
Some of the firstDMTs were approved by the FDAmore than 20 years ago. Examples include:
Some of these older medications are not as strong as more recently approved DMTs, Dr. Flanagan says. Even so, some patients prefer them because they’ve been around the longest, so their benefits, side effects, and risk factors are well known, he says. Plus, these medications tend to have milder side effects for some people.
坏处:第一代儿童可能没有the potency to help patients who are dealing with multiple MS attacks per year. If you have active MS with lots of inflammation showing up on your MRI, you may require newer-generation meds, Dr. Flanagan says.
另一个问题是，这些旧DMTS需要自我注射，在皮肤或肌肉，这可能会导致在注射部位擦伤和不适。
霍利山，谁在1988年被诊断为MS，开始使用倍泰龙不长才普及之后，但在注射给她留下可怕的瘀伤。她然后切换到Avonex的，这也是尽管是一个自我注射DMT来到副作用少，她说。希尔留在它约15年来，随着用药一次，每周有几个问题注入自己。
Oral and Infusion-Based Medications for MS
Oral medications are among the newer DMTs available. They may be seen as more convenient and appeal to patients who experience side effects from the injections, Dr. Flanagan says.
Examples of medications that can be taken by mouth include:
也有输液为主的药物，这是在医疗机构静脉注射。输注基于DMT通过IV直接递送到静脉，并不需要被经常施用自注射药物。
输注基于DMTS的实例包括：
Newer DMTs: The Risks You Need to Know
虽然大多数患者能够耐受药物的新井，他们做出来的副作用和感染风险更大，弗拉纳根博士说。其结果是，医生将监测病人谁更密切的那些药物。
一个这样的副作用被称为progressive multifocal leukoencephalopathy(PML), a serious and potentially fatal brain infection that is triggered by a virus called John Cunningham virus (JC virus) that more than 60% of adults have been exposed to, Dr. Flanagan explains. The virus usually remains dormant in healthy people, but because some DMTs alter how a person’s immune system functions, in rare cases, the virus can be re-activated in those who use DMTs.
People who take the infusion-based medication Tysabri seem to be at the highest risk of developing PML. Because of this, before a patient is ever prescribed this drug, they are tested to see if they’ve been exposed to the virus, Dr. Flanagan says.
“对于那些谁已经暴露于病毒的，我们尽量不使用服药，”弗拉纳根博士说。“但是，如果你还没有被曝光，它通常是安全的，我们监测血细胞计数，看看你是否已经成为暴露在病毒随着时间的推移”。
什么时候去瑞士tch Your DMT
There are a number of reasons why patients might switch off one DMT or try a new medication, Dr. Flanagan says. For instance, if you’re continuing to have new relapses and new active lesions are appearing on your MRI, the medication is likely not working for you.
“Alternatively, if patients develop side effects and just don’t tolerate the medication—they get abdominal pain, for example—then we might switch to a medication of a similar strength, hoping that they won’t get those side effects with the new medication,” Dr. Flanagan says.
Like Holly Hill, some patients may decide it’s time to switch medications as their MS progresses over the years. After being on Avonex for so long, Hill decided to try one of the newer oral medications. She’s since been onTecfidera), which is a tablet taken twice daily.
“I’ve tolerated that very well,” Hill says. “I’ve had no side effects at all.”
DMTs and MS: What You Need to Know About Pregnancy
None of these medications is approved by the FDA for women who are pregnant, plan to become pregnant, or who are breastfeeding, according to theNational Multiple Sclerosis Society。如果这是你，你的医务人员以确定最佳和最安全的治疗方案。
有一些药物，如Aubagio，如果你打算怀孕，今后应尽量避免，弗拉纳根博士说。这些药物可能会导致胎儿畸形，可能停留在一个女人的系统，一年或两年，她停止服用后，也他说。
The Bottom Line
All the disease-modifying therapies described above have been shown to be effective in treating MS. The key is working with your healthcare provider to find the one that offers the greatest benefit for you at this time--and monitoring your results in case it’s not working for you.
“我认为有一种药在那里为每一个病人，而是要看整体情况，并采取所有的因素都考虑在内是很重要的，”弗拉尼根博士说。一旦你这样做，你就可以做出决定，是适合你的。