• There isn’t a cure for multiple sclerosis (MS) in the foreseeable future, but this chronic illness is more manageable than ever before.
• Research is focused on finding ways to repair nerve damage caused by MS and protect against brain atrophy (shrinkage).
• There are four actions you can take now to improve your quality of life with MS until a cure is found.

Will we ever see a cure for multiple sclerosis? That’s one of the most frequently asked questions — and topics of conversation — among people living with this disease. “I’m so tired of feeling this way every day,” said one member of MyMSTeam. “I wish MS had a cure.” Another commented, “Praying that a cure for this disability is found in my lifetime!”

Although neuroscience researchers have more insights into possible causes of MS, we’re still a long way off from a cure, according to Dr. Aaron Boster. A board-certified neurologist and president of The Boster Center for Multiple Sclerosis in Columbus, Ohio, Dr. Boster also has a YouTube channel with a full video library that covers many aspects of treating and living with MS.

“I don’t really think that in my lifetime that we will cure the disease. I hope I’m wrong,” Dr. Boster said in an exclusive interview with MyMSTeam. ”And it’s not out of a lack of desire or effort.”

The good news: Scientists are honing in on ways to improve quality of life with MS, which affects nearly 1 million people in the U.S. More MS therapies are being developed than ever before, according to the National Multiple Sclerosis Society. The disease is also being diagnosed earlier, so disease-modifying treatments (DMTs) can begin sooner. And scientists are discovering possible risk factors that could eventually help prevent the disease.

In clinical trials, DMTs have been shown to help reduce the frequency and severity of MS flare-ups.

Thanks to these advances, MS is becoming a manageable chronic disease, Dr. Boster said. Like diabetes, MS may not be curable, but it can be managed with diet, lifestyle modifications, and medications.

“If we get ahold of it early, and we’re aggressive and it’s treated, then we can make the disease boring, so that you live your best life despite MS,” Dr. Boster explained. “That is realistic today in 2024.”

Closer to a Cure: Breakthrough Therapies for MS

MS is thought to occur when the body’s immune system attacks the central nervous system (CNS), causing inflammation that damages the myelin sheath, a protective coating around nerves of the brain and spinal cord. This neurological (nerve) damage disrupts the signals those nerves send to other parts of the body, causing common MS symptoms such as:

• Difficulty walking
• Spasticity
• Muscle weakness
• Fatigue
• Vision problems
• Tingling
• Numbness
• Cognitive issues, such as brain fog

“We’re only now starting to be able to impact areas of the immune system that we’ve never been able to reach before,” Dr. Boster told MyMSTeam.

Health experts believe that stopping inflammation is the key to stopping MS in its tracks. Dr. Boster identified three treatment types under development that are important steps toward improved quality of life — and possibly a cure:

• DMTs
• Remyelination treatment
• Neuroprotective therapies

Disease-Modifying Therapies

DMTs work by modifying immune system activity to slow the course of active MS. Although these drugs can’t cure MS, they’ve been highly effective at reducing the inflammation that causes nerve damage and slowing disease progression.

The U.S. Food and Drug Administration (FDA) has approved more than 25 DMTs, which can be administered orally or by injection or infusion. In clinical trials, DMTs have been shown to help reduce the frequency and severity of flare-ups. They can also reduce the development of new lesions and slow disability. New DMTs continue to be developed for more effective treatment of MS.

DMTs are prescribed primarily for people with relapsing forms of MS, which include relapsing-remitting MS (RRMS), clinically isolated syndrome (CIS), and active secondary-progressive MS (SPMS). They include drugs in several different classes that work in different ways.

Here are some classes of DMTs along with examples:

• Injected interferons such as interferon beta-1a (Avonex), interferon beta-1b (Betaseron), and peginterferon beta-1a (Plegridy)
• Oral sphingosine-1-phosphate (S1P) receptor modulators such as fingolimod (Gilenya), siponimod (Mayzent), and ozanimod (Zeposia)
• Oral fumarates including dimethyl fumarate (Tecfidera) and diroximel fumarate (Vumerity)
• Injected monoclonal antibodies, also known as biologics, such as natalizumab (Tysabri), alemtuzumab (Lemtrada), and ocrelizumab (Ocrevus)
• Glatiramer acetate (Copaxone), which is also injected
• Cladribine (Mavenclad), an oral medication

Read more about specific medications in this list of treatments for MS.

In addition to treating relapsing MS, ocrelizumab is the first and only DMT approved by the FDA to treat primary progressive MS (PPMS).

“We’re probably a few years out from having remyelinating agents available. That’s a short period of time.”

— Dr. Aaron Boster

Although DMTs are the best defense against MS to date, each person responds differently to the medications, and the drugs can have a risk of significant side effects. Your neurologist can recommend the best treatment options and discuss potential side effects for your type and stage of MS. In partnership with your neurologist, you’ll make decisions about when to start, stop, or switch MS medications.

Remyelination Treatment

Although DMTs can reduce inflammation that damages nerves, they can’t stop or repair damage that has already occurred. Remyelination treatment would change that.

“We’re probably a few years out from having remyelinating agents available. That’s a short period of time,” said Dr. Boster, who shared that he has taken part in several “really exciting” trials.

According to one group of researchers, treatments aimed at remyelination are likely to become available within the next decade. Scientists are currently studying ways to stimulate the brain’s natural ability to repair damaged nerves in a person with MS.

A few of the compounds currently being studied for remyelination include:

• S1P receptor modulators, some of which are already approved as DMTs
• Clemastine fumarate, an antihistamine (anti-allergy drug)
• Sex hormones such as testosterone

Results from these and other clinical studies will hopefully make it clear which remyelination strategies are most likely to be safe and effective for people with MS.

Neuroprotective Therapies

Researchers are also investigating therapies that could slow brain atrophy, one of the most destructive actions of progressive MS and a reliable predictor of future physical and cognitive disability.

“We know that people impacted by MS have accelerated shrinkage of the brain and lose their functional reserve,” said Dr. Boster. “We need something to protect against that.”

Unfortunately, he added, a neuroprotective agent doesn’t yet exist.

But neurology research is advancing nonetheless: “We have had multiple failures in the last couple of years — remodeling agents that haven’t worked, neuroprotective agents that haven’t worked. And that breaks my heart. But each time we do that we become slightly smarter.”

A few examples of medications being studied for their potential neuroprotective abilities include:

• Bruton’s tyrosine kinase inhibitors (BTK inhibitors) such as evobrutinib
• Phosphodiesterase (PDE) inhibitors such as ibudilast
• Minocycline, a tetracycline antibiotic
• Forms of coenzyme Q10 such as mitoquinone

“We know that people impacted by MS have accelerated shrinkage of the brain and lose their functional reserve. We need something to protect against that.”

— Dr. Aaron Boster

If studies can show that one or more drugs can safely prevent the worsening of brain atrophy in MS, new treatments focused on neuroprotection may be forthcoming.

Experimental Treatments in Development

Ongoing research in the treatment of MS continues to expand, and more experimental therapeutics are emerging with the potential of new treatments becoming available in the next 10 years. Along with studies of neuroprotective therapies, researchers are investigating immunomodulatory treatments, bone marrow transplantation, and personalized medicine as promising areas of research.

Breakthroughs in gene research are identifying genetic variants and genetic biomarkers associated with disease activity in people with MS. Genetic biomarkers, also known as genetic markers, can help identify who is susceptible to disease. Genetic research is one avenue that may lead to new types of treatment for MS.

“Each time there’s a little bit of research, we add a pebble onto a pile of tasks. And each little tiny piece of information gives us more and more knowledge and more and more tools. And the totality of that will eventually reach the peak,” Dr. Boster said.

Dr. Boster’s Four Strategies for Managing MS

Until a cure is discovered, Dr. Boster says the best defense against MS is fourfold. He recommends the following strategies for improving your quality of life with MS. Talk to your health care team if you need help managing your condition.

1. Find the Best DMT for You

Deciding on an MS treatment requires a careful discussion with your neurologist to determine which medication is right for you. “I want [my patients] to take the most effective DMT they’re comfortable with,” Dr. Boster explained. “I also want to make sure it’s working for them.”

2. Get Moving

Aside from promoting good health in general, physical activity can help manage many symptoms of MS. “Exercise should be part of your lifestyle,” Dr. Boster said.

3. Follow the Two D’s

Vitamin D and diet are essential to good MS defense, according to Dr. Boster. Low levels of vitamin D are common in people with MS. You can ask your doctor to check your vitamin D levels with a blood test. If you have low levels of the vitamin, Dr. Boster recommends discussing supplementation with your physician.

Diet is another important MS defense. A nutritious, well-balanced diet has the potential to reduce symptoms and improve quality of life. The National Multiple Sclerosis Society recommends the following:

• Prepare meals at home as often as possible,
• Eat colorful fresh fruits and vegetables daily.
• Opt for whole grains over refined grains.
• Avoid or limit how much processed food and added sugar you consume.

Try these ideas for healthy snacks and quick bites.

4. Kick Butts

Smoking has been shown to increase the risk of developing MS, promote disease activity, and worsen symptoms and disability progression. It may also inhibit the benefits of DMTs. It’s very important to avoid tobacco, Dr. Boster warned.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 213,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Do you follow news about MS research and the search for a cure? What works for you to manage your MS until a cure becomes available? Share with others in the comments below or by starting a new conversation on MyMSTeam.