This guideline covers diagnosing and managing multiple sclerosis in people aged 18 and over. It aims to improve the quality of life for adults with multiple sclerosis by promoting symptom management, comprehensive reviews and effective relapse treatment.
The guideline does not cover disease-modifying treatments. These are covered by the technology appraisals on NICE's webpage on multiple sclerosis.
In November 2019, we replaced the recommendation on using Sativex (a THC:CBD spray) to treat spasticity in people with multiple sclerosis with a cross-reference to recommendations on THC:CBD spray in the NICE guideline on cannabis-based medicinal products.
In July 2019, we updated a footnote in this guideline to reflect a change in the law relating to gabapentin. As of 1 April 2019, because of a risk of abuse and dependence gabapentin is controlled under the Misuse of Drugs Act 1971 as a class C substance and scheduled under the Misuse of Drugs Regulations 2001 as schedule 3.
This guideline includes recommendations on:
- providing information and support
- modifiable risk factors for relapse or progression
- symptom management and rehabilitation
- comprehensive review
- relapse and exacerbation
Who is it for?
- Healthcare professionals
- Social care practitioners
- Commissioners and providers
- Adults with multiple sclerosis and their families and carers
Is this guideline up to date?
Guideline development process
This guideline updates and replaces NICE guideline CG8 (November 2003).
This guideline was previously called multiple sclerosis: management of multiple sclerosis in primary and secondary care.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.