A recent publication reviewed the available evidence on the effects of MS drugs on relapses, disability and safety. The authors conclude that while some of the common drugs seem to be useful in preventing relapses, the sometimes very serious side-effects are not well documented, and the long term (> two years) effects are not clear.
Another major concern is that most (>70%) research into these drugs was funded by pharmaceutical companies themselves.
Finally, there is currently not enough evidence that these drugs prevent a worsening of disability. Some people might find it helpful to print out this article and bring to their neurologist when discussing individual therapy options.
A selected quote from the Authors' conclusions: "Our review shows that alemtuzumab, natalizumab, and fingolimod are the best choices for preventing clinical relapses in people with RRMS, but this evidence is limited to the first 24 months of follow-up.
For the prevention of disability worsening in the short term (24 months), only natalizumab shows a beneficial effect on the basis of moderate quality evidence (all of the other estimates were based on low to very low quality evidence).
Currently, therefore, insufficient evidence is available to evaluate treatments for the prevention of irreversible disability worsening.
"There are two additional major concerns that have to be considered. First, the benefit of all of these treatments beyond two years is uncertain and this is a relevant issue for a disease with a duration of 30 to 40 years. Second, short-term trials provide scanty and poorly reported safety data and do not provide useful evidence in order to obtain a reliable risk profile of treatments.
In order to provide long-term information on the safety of the treatments included in this review, it will be necessary also to evaluate non-randomised studies and post-marketing reports released from the regulatory agencies. Finally, more than 70% of the studies included in this review were sponsored by pharmaceutical companies and this may have influenced the results.”