2.1 Definition and impact of a relapse
2.2 Treating a relapse
2.3 The role of the nurse
2.4 Reflection and references
3.0 Disease modifying treatments
3.1 An introduction to DMTs
3.1.1 Mechanism of action
3.2 DMTs for relapsing MS
3.2.1 Moderately effective DMTs
3.2.1.1 Dimethyl fumarate
3.2.1.2 Diroximel fumarate
3.2.1.3 Glatiramer acetate
3.2.1.4 Interferons
Interferon β-1a (Avonex)
Interferon β-1a (Rebif)
PEG Interferon β-1a (Plegridy)
Interferon β-1b (Betaferon)
Interferon β-1b (Extavia)
3.2.1.5 Teriflunomide
3.2.2 More/strongly effective DMTs
3.2.2.1 Cladribine
3.2.2.2 Fingolimod
3.2.2.3 Ozanimod
3.2.2.4 Ponesimod
3.2.3 Highly effective DMTs
3.2.3.1 Alemtuzumab
3.2.3.2 Natalizumab
3.2.3.3 Ocrelizumab
3.2.3.4 Ofatumumab
3.2.3.5 Ublituximab
3.3 DMTs for progressive MS
3.3.1 Siponimod
3.3.2 Ocrelizumab
3.4 Generics and biosimilars
3.4.1 Biosimilar natalizumab
3.5 DMT selection
3.5.1 Factors to consider
3.5.2 Shared decision-making
3.5.3 Switching or stopping DMTs
3.6 Role of the nurse
3.6.1 Providing education/information
3.6.2 Management of side effects
3.6.2.1 Common side effects and how to manage them
3.6.3 Promoting adherence
3.7 Reflection and references
4.0 Stem cell therapy
4.1 Efficacy and safety
4.2 Nursing considerations
4.3 Reflection and references
5.0 Symptomatic treatments
5.1 Walking
5.2 Spasticity
5.3 Fatigue
5.4 Bladder dysfunction
5.5 Bowel dysfunction
5.6 Sexual dysfunction
5.7 Depression
5.8 Cognition
5.9 Pain
5.10 Cannabidiol use for treating symptoms in MS
5.11 Reflection and references
6.0 Non-established therapies
6.1 Reflection and references
Case study
Management issue 1
Recommended approach
Management issue 2
Recommended approach
Case conclusion
