The older injectible therapies (Copaxone, Rebif, Avonex and Betaseron), also known as the CRAB drugs, are all for RRMS. The exception is Betaseron, which is also used for PRMS, a relatively rare form of MS. Tysabri is also for RRMS, and is used in cases where people cannot tolerate or have not responded well to the CRAB drugs.
Novantrone is a drug that is used for some of the progressive forms of MS (SPMS and PRMS). It is given by infusion in the doctor’s office once every three months. However, even if you have one of the forms of MS that Novantrone is approved for, Novantrone might not be for you, as it has serious side effects and, in most cases, cannot be used by anyone who has cardiac problems or who has had chemotherapy.
Unfortunately, if you have PPMS, none of the current disease-modifying therapies is appropriate.
It is also important to note that most MS medications have been tested only in people under the age of 65, as this is often one of the inclusion criteria in clinical trials. While it is not expected that simply being older would be a factor that would make any of the approved drugs dangerous or less effective, it is possible that side effects may be worse.
Having stated some of the reasons why your neurologist might not prescribe one of the disease-modifying treatments, that does not mean that there is nothing that can be done to help your MS. Many treatments are available to help with the MS symptoms that you might be experiencing. In addition, your doctor can prescribe physical therapy, which can help build your muscles and help you learn techniques to compensate for loss of function in certain areas. Occupational therapists can help you to modify your home and your actions to make it easier to do daily activities and self-care. This could include things like adding a bath transfer bench to make it easy to get in and out of the bathtub or rearranging kitchen cabinets to reduce the need to bend down to get items.
If you feel like your doctor is doing all that she can for you, or is not treating your MS as aggressively as she could because of your age, do not hesitate to find a neurologist (preferably one with a larger geriatric patient population) and get a second opinion.
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