Long-term disease-modifying therapy for MS includes which options?

• A. Antibiotics
• B. Monoclonal antibodies or interferons
• C. Antipsychotics
• D. Anticonvulsants

Answer: (B)

In MS, long-term disease-modifying therapy aims to alter the immune-driven inflammation in the central nervous system, reducing relapse frequency and slowing disability progression rather than just treating symptoms.

The main long-term options are therapies that modulate or suppress the immune system, including interferon-based treatments and monoclonal antibodies. Interferons (beta-1a/b) help dampen inflammatory T-cell activity and cytokine production and help stabilize the blood-brain barrier, leading to fewer inflammatory lesions. Monoclonal antibodies target specific immune pathways to reduce CNS inflammation; for example, some prevent white blood cells from entering the brain, while others deplete particular immune cell subsets implicated in MS. These agents are used chronically with ongoing monitoring for side effects.

Antibiotics address infections, not the autoimmune process of MS. Antipsychotics manage certain psychiatric or behavioral symptoms, and anticonvulsants control seizures or neuropathic pain; none of these modify the disease course of MS.

So, the long-term disease-modifying options are monoclonal antibodies or interferons.