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First, it's completely understandable to feel overwhelmed and sad right now. Fifteen years of stability is a huge achievement, and a relapse after that long can feel like the rug has been pulled out from under you. Those feelings are valid, and many MyMSTeam members have shared similar emotional experiences when facing a Show Full Answer

First, it's completely understandable to feel overwhelmed and sad right now. Fifteen years of stability is a huge achievement, and a relapse after that long can feel like the rug has been pulled out from under you. Those feelings are valid, and many MyMSTeam members have shared similar emotional experiences when facing a treatment change.

The good news is that your neurologist is being proactive, and you have real options in front of you. Here's a quick overview of the three DMTs recommended to help frame your research and conversations:

Aubagio (teriflunomide)
- Taken as a daily oral pill — no injections or infusions
- A moderate-efficacy DMT
- Requires regular liver function monitoring
- Not recommended if pregnancy is a possibility, as it can remain in the body for a long time

Kesimpta (ofatumumab)
- A self-administered injection given monthly (after initial doses)
- Considered a high-efficacy DMT
- Works by targeting specific immune cells (B cells)
- May increase infection risk due to immune suppression

Ocrevus (ocrelizumab)
- Given as an intravenous infusion twice a year at an infusion center
- Also a high-efficacy DMT targeting B cells
- Requires monitoring for infusion reactions and infection risk
- Well-established track record in the MS community A few important things to keep in mind as you decide:

- Efficacy vs. lifestyle: Kesimpta and Ocrevus are both considered high-efficacy options, which some neurologists prefer after breakthrough disease activity. Aubagio is more convenient but generally considered less aggressive.
- Therapeutic lag: All DMTs take time to reach full effectiveness — anywhere from 3 to 16 months — so patience after switching is important.
- Washout period: Ask your neurologist if a washout period is needed when transitioning from Avonex, and whether that increases your short-term relapse risk. Some great questions to bring to your next appointment include:

1. Which of these options does she feel is most appropriate given your recent relapse history?
2. What side effects should be most closely monitored with each option?
3. How will you know if the new DMT is working?
4. What does your insurance cover?

Many MyMSTeam members have navigated this exact crossroads and gone on to find stability again. You're asking all the right questions, and that's a really strong place to start. 💙

 AI-generated responses are not a substitute for medical advice. These services are not intended to diagnose, treat, or cure any condition or disease. Always ask your doctor about specific health concerns.

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