Disease Modifying Therapies

This group of medication are prescribed by an MS Neurologist. Within Hereford we have general Neurologists who visit from the QE in Birmingham.

Therefore if the Hereford Neurologists or MS Nurses feel that you may meet the criteria for these medications, then they will refer you to the QE MS Neurologists. Once referred the average wait for an appointment is 3 months. 

The QE Neurologist will gage how active your MS is:
Active RRMS: 2 relapses in the past 2 years
Highly Active RRMS: if you relapse after a year of DMT or have had 2 or more severe or disabling relapses in the previous year and show an active scan on 2 consecutive occasions.

If you are meet the criteria for the medications, the Neurologists will direct you to which group of medications would be suitable. Then it’s up to the Hereford MS Nurses to explain all of those medications and help you decide which one would be suitable for you. 

The Hereford team would also obtain bloods prior to the start of the medications as part of the screening process. As well as completing pre-screening documents.

For Relapsing Remitting Disease, depending how active your MS is, you will be offered either “1st Line/Escalation” or “2nd Line/Induction” therapies.
1st Line: For Active RRMS
Aubagio, Avonex, Betaferon/Extavia, Copaxone/Bravio, Rebif, Plegridy, Tecfidera and Ocrevus, Kesimta.
2nd Line: For Highly Active RRMS
Tysabri, Ocrevus, Gilenya, Mavenclad, Lemtrada, Kesimta. 

For people with Secondary Progress Disease, who continue to relapse or have changes on their MRIs, you will be offered:
Siponimod/Mayzent (QE has not started this treatment as of yet).

For people with Primary Progressive disease who have had PPMS less than 15yrs, can walk more than 20 meters and have signs of activity on an MRI, you will be offered:
Ocrevus.