I have to start by saying that every patient with MS is different so you really do need to speak to your doctor. Fingolimod (Gilenya) was approved about one year ago. There were some safety concerns in the trial including two fatal infections in a higher dose and multiple low-grade cancers in the currently available dose so we have been cautious about its use. However, no new safety concerns have arisen in the year since it has been on the market. The phase III trials for teriflunomide and BG 0012 were just completed with impressive safety and good efficacy results. Another oral medication, called Laquinimod, will be finishing one of its phase III trials soon. All of these medications have a unique effect on the immune system. They are not simply oral versions of your current medication. Also every person’s immune system is different based on what they’ve encountered in their life and their genes. The different mechanism of action of these medications may affect each person’s MS differently. Therefore, if you’re stable on your current treatment, you do run the risk of disease activity during the switch. Despite the promising trial results, the long term safety of these new drugs has not been established. That’s not to say we have to wait years before trying them but it’s an important point to remember. Finally, just because they’re new drugs, doesn’t necessarily mean they’re better. Our use of oral medications in MS is already increasing dramatically. That trend will continue but there needs to be careful consideration of the risks of side effects (short and long term) as well as the risk of disease activity in a patient who is stable on their current treatment. Dr. Stark