Multiple sclerosis

Chronic inflammatory demyelinating disease of the central nervous system. Diagnosis by McDonald 2017 criteria – clinical attacks plus MRI evidence of dissemination in space and time. Per AAN 2022 and SEN 2024, disease-modifying therapy (DMT) is started early: high-efficacy (natalizumab, ocrelizumab, cladribine) or moderate-efficacy (dimethyl fumarate, teriflunomide, fingolimod). Target – NEDA-3 (no evidence of disease activity).

ICD-10 G351 drug

Also known as: MS, Relapsing-remitting MS

Drugs used for this condition

ADimethyl FumarateFirst line · Immunomodulator for disease-modifying therapy of multiple sclerosisRelapsing-remitting multiple sclerosis in adults. Per AAN 2022 and SEN 2024 – moderate-efficacy disease-modifying therapy. Dose: 120 mg twice daily for 7 days, then 240 mg twice daily. Take with food – reduces flushing seen in 30–40% during the first weeks. Baseline: JC virus serology, CBC, lymphocytes, ALT.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit