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Is there a change of paradigm towards more effective treatment early in the course of apparent high-risk MS?

Authors :
Fernández, Óscar
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