This article reviews and discusses the approved and emerging therapies for 
multiple sclerosis (MS). MS is a chronic and disabling immune-mediated disease 
of the central nervous system (CNS) that affects mainly young adults. MS imposes 
a huge economic burden on healthcare systems and the society. Although the last 
20 years have brought a continuous expansion in therapeutic options, there are 
still unmet needs in MS management. Available MS drugs have varying degrees of 
efficacy in reducing relapse risk. The long-term term effects of these 
treatments are incompletely known. New therapies, along with variations of 
currently available treatments, may prove more effective and tolerable than the 
available drugs. Treatments for MS differ with respect to the mode of 
administration, tolerability and likelihood of treatment adherence, side 
effects, and risk of major toxicity. The armamentarium of approved 
disease-modifying therapies in MS and those in development include: (1) the 
first approved, moderately effective, injectable interferon-β and glatiramer 
acetate; (2) oral drugs (fingolimod, laquinimod, teriflunomide, dimethyl 
fumarate); (3) monoclonal antibodies (rituximab, ocrelizumab, ofatumumab, 
daclizumab, alemtuzumab); and (4) immunosuppressive agents (e.g. mitoxantrone). 
The place of each drug in the therapeutic algorithm is dependent on its specific 
risk-benefit profile. Patients' clinical and paraclinical phenotypes and 
biomarker profile may help to elucidate disease subtypes and response to therapy 
in the future, thus allowing treatment individualization.