MSFrontier

Symptoms and everyday function

Which treatments make daily life with MS better?

In short

Much of what people with MS live with each day is symptoms: fatigue, walking difficulty, stiffness, pain, bladder problems, and changes in thinking and mood.

Treating them improves daily life now, whatever the course of the disease. Trials test medicines, rehabilitation, exercise, devices and psychological therapies.

Some treatments have clear evidence, such as fampridine for walking speed in some people and exercise for fatigue and fitness. For many symptoms the trials are small and the effects modest or uncertain.

Background in MS in depth

Hypotheses by status

  • Confirmed 2
  • Supported by one trial 1
  • Promising 1
  • Mixed 3
  • Results pending 6
  • Being tested 27
  • Failed early 2
  • Disproven 3
  • No clear answer 37
82
Hypotheses
153
Trials recruiting
5
Phase 3 running
32
Readouts in 90 days

Most recent results

Next readouts

ConfirmedSupported by one trialPromisingMixedResults pendingBeing testedFailed earlyDisprovenNo clear answerNot yet tested

Symptom trials differ from trials of disease-modifying medicines. They usually last weeks or months, they measure how a person walks, feels or functions rather than relapses or scans, and many test rehabilitation or devices rather than medicines. This makes them quicker to run, but also harder to compare, because each uses its own measures.

Walking is the best studied. In a phase 3 trial of 301 people, 35 per cent of those taking fampridine walked consistently faster, against 8 per cent on placebo. Those who responded also reported less walking difficulty.[1] Fampridine helps only some people, so it is usually continued only in those who improve.

Fatigue is the most common symptom and one of the hardest to treat. A Cochrane review of exercise therapy found that exercise reduced self-reported fatigue compared with no exercise, although the trials were small and varied in design and the people they included.[2] Medicines tested for fatigue have shown small or inconsistent effects.

Other areas include spasticity (baclofen, tizanidine, botulinum toxin and cannabis-based medicines), bladder problems (medicines, bladder-wall injections of botulinum toxin and nerve stimulation), pain, mood and thinking. The hypotheses and trials below show which have been tested, and with what result.

References

  1. 1.Goodman AD, et al. Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial. Lancet 2009. doi:10.1016/S0140-6736(09)60442-6
  2. 2.Heine M, et al. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev 2015. doi:10.1002/14651858.CD009956.pub2

Background in MS in depth

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