You are one of the pioneers in using immunosuppressive medications like cyclophosphamide in the treatment of multiple sclerosis. These medications have been used for quite some time. Now there is more disease-modifying Multiple Sclerosis therapies that are becoming available. What is the role for immunosuppressive medications in treatment of multiple sclerosis? Dr. Anton Titov, MD. Almost all of the medications we have for Multiple Sclerosis affect the immune system. Dr. Howard Weiner, MD. I would call them immune modulators. One of the newest medications that just came out targets B-cells. That medication has a very good effect in multiple sclerosis. That is probably the latest big medication we have for multiple sclerosis. Dr. Howard Weiner, MD. We don't use a lot of cyclophosphamide anymore. Our work on cyclophosphamide was a breakthrough that showed the immune suppression or immune modulation. Dr. Howard Weiner, MD. We now have more sophisticated medications. But the new medications affect cells that the cyclophosphamide affected. For example, cyclophosphamide affected B-cells. Now we have new medication that affects B-cells. Is that injectable or oral multiple sclerosis medications? Dr. Anton Titov, MD. The new Multiple sclerosis medication targets B-cells by infusion. Then there is other oral multiple sclerosis medications that target other cells. This newer multiple sclerosis medications. How is their risk profile and side-effects? Dr. Anton Titov, MD. Because obviously immunosuppressive therapy has a lot of side effects. How is the risk profile of newer multiple sclerosis medications compared to the classical multiple sclerosis medications? Dr. Anton Titov, MD. Newer medications don't have as many risks. The new anti B-cell antibodies are not as risky as the old immunosuppressants. They have a much better risk profile for the patient with multiple sclerosis? Dr. Anton Titov, MD. Yes. New therapies for multiple sclerosis target specific immune cells, like B-cells. Leading MS expert explains.