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Is there a change of paradigm towards more effective treatment early in the course of apparent high-risk MS?
- Source :
- Multiple Sclerosis and Related Disorders; October 2017, Vol. 17 Issue: 1 p75-83, 9p
- Publication Year :
- 2017
-
Abstract
- Aggressive, highly active, or rapidly evolving severe relapsing-remitting multiple sclerosis (RRMS) is characterized by frequent relapses and active disease on magnetic resonance imaging, ultimately leading to a high risk for rapid disability accumulation. The treatment approach for high-risk patients is evolving into a model of individualized therapy in which early initiation of high-efficacy disease-modifying therapy (DMT), which I refer to as “early and strong” therapy, is viewed as a rational strategy to prevent the irreversible damage that occurs at disease onset and early in the disease course. This approach uses an individualized benefit-risk assessment to match the level of DMT efficacy with the patient's risk of disease progression and balances it against the risk of drug-related adverse events. It also includes consideration of the patient's risk tolerance and desire for a high-efficacy treatment. This paper discusses the rationale for early treatment, and summarizes the available clinical data on high-efficacy and moderately-high efficacy DMTs in patients with high-risk RRMS.
Details
- Language :
- English
- ISSN :
- 22110348
- Volume :
- 17
- Issue :
- 1
- Database :
- Supplemental Index
- Journal :
- Multiple Sclerosis and Related Disorders
- Publication Type :
- Periodical
- Accession number :
- ejs42685218
- Full Text :
- https://doi.org/10.1016/j.msard.2017.07.003