Assembled by software from public sources.
Preventing MS
What starts MS, and can it be prevented or delayed?
Some treatments3 confirmed · 4 running · 2 failed
In short
Most people catch the Epstein-Barr virus and never develop MS, yet almost everyone with MS has had it. Genes and other factors such as smoking, low vitamin D and obesity in adolescence decide who is at risk.
If the trigger can be stopped, MS could be prevented rather than treated. This page follows the trials testing that idea.
Vaccines against the virus are in early trials, and treating people whose scans show changes before any symptoms has delayed the first attack in two trials.
MS does not begin on the day of the first symptom: in the years before diagnosis people see doctors more often and their stored blood already shows signs of nerve damage and antibodies against the Epstein-Barr virus. This period, the prodrome, is the window in which prevention would have to act.[1][2][3][4]
Where we are
- Almost everyone with MS has had the Epstein-Barr virus, and infection raises the risk about thirtyfold. Whether stopping the virus prevents MS has not been tested in people.
- Treating people whose scans show MS-like changes before any symptoms delays the first attack (ARISE, TERIS). That is early treatment, not prevention.
- Two EBV vaccines and an EBV-directed T-cell therapy are in early trials. A true prevention trial would need thousands of healthy people followed for years, and none exists yet.
- Smoking, low vitamin D and obesity in adolescence raise the risk, but no trial has shown that changing them prevents MS.
Written by the editors from the records below. Last reviewed 6 November 2026. Not yet reviewed by an MS specialist.
The evidence
What works
- Glatiramer acetate · Early MS (CIS or RIS)
Glatiramer acetate
- Interferon beta · Early MS (CIS or RIS)
Interferon beta-1a
- Immune reconstitution (cladribine, alemtuzumab, aHSCT) · Early MS (CIS or RIS)
Cladribine · one trial
Being tested
- Tenofovir alafenamide · MS (type not specified)
Tenofovir alafenamide · 1 trial running
- Integrin blockade (lymphocyte trafficking) · Early MS (CIS or RIS)
Natalizumab · 1 trial running
- Riluzole · Early MS (CIS or RIS)
Riluzole · Awaiting result
Did not work
- Temelimab · Relapsing MS
Temelimab
What comes next
Open questions
- Does treating Epstein-Barr virus change the course of MS?Trials running
- Can T cells trained against EBV-infected cells help people with MS?Nothing running
- Can treating a first episode, or MRI changes alone, delay or prevent MS?Trials running
- Does vitamin D, or another supplement, reduce disease activity?Nothing running
- Does a particular diet change the course of MS?Trials running
Further reading
Reviews and guidelines
No reviews are linked to this area yet.
Lab research
No lab studies are linked to this area yet.
References
- 1. Bjornevik K, et al. Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Science 2022.
- 2. Tremlett H, Marrie RA. The multiple sclerosis prodrome: emerging evidence, challenges, and opportunities. Mult Scler 2021.
- 3. Okuda DT, et al. Dimethyl fumarate delays multiple sclerosis in radiologically isolated syndrome (ARISE). Ann Neurol 2023.
- 4. Lebrun-Frenay C, et al. Teriflunomide and time to clinical multiple sclerosis in patients with radiologically isolated syndrome (TERIS). JAMA Neurol 2023.