Despite all of your efforts in adhering to a therapy, at some point you and your doctor may decide a new line of defense is in order if your current medication does not appear to be effective for you. There are several reasons someone who is committed to drug therapy may decide to switch from one treatment option to another, including a significant number of relapses, signs of disability progression, or new MRI lesions. Side effects and problematic injection-site reactions should also be discussed with your doctor, but she may be able to help you manage them.

Deciding to switch therapies is an important decision and one that must be made by both you and your physician. Although MS researchers and physicians are currently trying to come up with guidelines that will help better define the criteria for changing therapies, some of the indications listed above may be used as a marker to aid your doctor in making an informed decision.

While interferons (Avonex, Betaseron, and Rebif) and Copaxone have been shown to have beneficial effects in MS, it may take months for these drugs to produce their full therapeutic effects. What this means for you is that a poor initial response to treatment doesn't necessarily mean the treatment isn't working. Your doctor may advise you to wait at least a year until you discuss changing to another therapy.

Education is your biggest ally when it comes to the disease-modifying therapies. Knowing the potential side effects, setting realistic expectations, and troubleshooting potential problems will assist you in your goal to make DMTs a successful part of your management plan.

Neutralizing Antibodies (NAbs) and the Interferons

A small percentage of people can produce antibodies, which are a type of protein that may fight off the interferon that is trying to help them. In this scenario, the immune system seems to fend off the interferon with antibodies that may decrease the treatment's effectiveness. NAbs usually develop within twelve to eighteen months after the start of treatment. Researchers have discovered that not all the interferons generate the same amount of these antibodies. Also note that a percentage of those who develop NAbs continue to do well on a specific treatment. In others, NAbs may be present for only a short time period (such as a few months), and in these cases are probably insignificant.