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Multiple Sclerosis Community

Reply: Optic Neuritis

There are a lot of issues in this thread to discuss. Optic neuritis can...

Posted by Jeffrey A Rumbaugh, MD, PhD

9 Replies | Reply | Watch This DiscussionReport This| Share this:Optic Neuritis There are a lot of issues in this thread to discuss. Optic neuritis can...

Reply: neuropathy

Unfortunately, I am not able to decipher what part of the brain might...

Posted by Jeffrey A Rumbaugh, MD, PhD

1 Reply | Reply | Watch This DiscussionReport This| Share this:neuropathy Unfortunately, I am not able to decipher what part of the brain might...

Reply: New Genes Linked to MS - How does this affect you?

The future of medicine (MS and otherwise) is personalized medicine....

Posted by Jeffrey A Rumbaugh, MD, PhD

2 Replies | Reply | Watch This DiscussionReport This| Share this:New Genes Linked to MS - How does this affect you? The future of medicine (MS and otherwise) is personalized medicine....

Reply: Hives

The symptoms you describe (hives/rash, chest pain going through to the...

Posted by Jeffrey A Rumbaugh, MD, PhD

16 Replies | Reply | Watch This DiscussionReport This| Share this:Hives The symptoms you describe (hives/rash, chest pain going through to the...

Reply: Question for doctor: Nerve pain

I am not able to offer advice on your case specifically. The symptoms...

Posted by Jeffrey A Rumbaugh, MD, PhD

1 Reply | Reply | Watch This DiscussionReport This| Share this:Question for doctor: Nerve pain I am not able to offer advice on your case specifically. The symptoms...

Reply: Optic Neuritis question (and also one about spinal...

Yes, optic neuritis could consist of just pain without vision changes,...

Posted by Jeffrey A Rumbaugh, MD, PhD

11 Replies | Reply | Watch This DiscussionReport This| Share this:Optic Neuritis question (and also one about spinal tap results) Yes, optic neuritis could consist of just pain without vision changes,...

Reply: weight gain

Weight gain is not a typical side effect of Rebif, Copaxone, and the...

Posted by Jeffrey A Rumbaugh, MD, PhD

8 Replies | Reply | Watch This DiscussionReport This| Share this:weight gain Weight gain is not a typical side effect of Rebif, Copaxone, and the...

Reply: Uncommon symptoms?

Multiple sclerosis can cause basically any symptom that can be...

Posted by Jeffrey A Rumbaugh, MD, PhD

5 Replies | Reply | Watch This DiscussionReport This| Share this:Uncommon symptoms? Multiple sclerosis can cause basically any symptom that can be...

Reply: Possible MS..your opinions Please!

Without a full evaluation, it is impossible to comment on a specific...

Posted by Jeffrey A Rumbaugh, MD, PhD

9 Replies | Reply | Watch This DiscussionReport This| Share this:Possible MS..your opinions Please! Without a full evaluation, it is impossible to comment on a specific...

Reply: Ms Treatment therapies and side effects. Your opin...

There is no one answer to this question which fits all patients. There...

Posted by Jeffrey A Rumbaugh, MD, PhD

There is no one answer to this question which fits all patients. There are pros and cons to all the meds and you have to gear the best choice to the individual patient. Sometimes I give the patient the info and let him/her make the decision based on his/her own values as to how he/she weighs the pros and cons. In other cases, there may be something specific about the patient so that I strongly recommend one of the choices over the others.

There are really 3 first line choices: high dose high frequency interferon (Rebif or Betaseron), low dose low frequence interferon (Avonex), and glatiramir acetate (Copaxone). There are also three key factors to way in deciding which to be on: efficacy (how well it controls MS), side effects, and injection frequency.

Rebif or Betaseron: most efficacy, most side effects (though you never know if you will have side effects until you try it), intermediate injection frequency (three times per week or every other day).

Avonex: least efficacy, intermediate side effects, lowest injection frequency (once per week)

Copaxone: high efficacy (nearly as high, or maybe even equal to Rebif/Betaseron), least side effects (most people have none), highest injection frequency (daily)

Your other options are all second or third line, meaning they really should only be used if you have failed the first line drugs. They might be more efficacious than the first line drugs, but they all have the potential for serious adverse effects, even death, which make them the right choice for only a carefully selected group of patients. These include Tysabri, Gilenya, and Novantrone.

Being on no medicine may be a good choice for patients with progressive MS but is a bad choice for patients with relapsing remitting MS. The medicines work very well in preventing disability. Most of the patients that we see today in wheelchairs or bedbound from MS are ones who have had the MS for 30 or 40 years (before medications were available) or who, for whatever reason, did not take medication for much or all of the time that they have had MS.View Thread

Posted byJeffrey A Rumbaugh, MD, PhD

59 Replies | Reply | Watch This DiscussionReport This| Share this:Ms Treatment therapies and side effects. Your opinion on Best and Worst There is no one answer to this question which fits all patients. There...

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