Patricia Coyle, MD

Diagnosis of Multiple Sclerosis: The McDonald Criteria

Differential Diagnosis of Multiple Sclerosis

MOG-IgG in Multiple Sclerosis

Clinically Isolated Syndrome Versus Multiple Sclerosis

First-Line Therapies for Relapsing Multiple Sclerosis

The Use of Interferon in Multiple Sclerosis

The Use of Glatiramer Acetate in Multiple Sclerosis

Clinical Trials for Cladribine in Multiple Sclerosis

Treating With Cladribine in Multiple Sclerosis

Role of Siponimod in Multiple Sclerosis

Ocrelizumab for the Treatment of Multiple Sclerosis

Role of Ocrelizumab in Europe for Multiple Sclerosis

Role of Diroximel Fumarate in Multiple Sclerosis

Role of Ozanimod in Multiple Sclerosis

Switching Therapies in Multiple Sclerosis

Decision-Making Process for Treating Multiple Sclerosis

The Future of Treating Multiple Sclerosis

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Global Approaches to the Management of Relapsing Multiple Sclerosis

“It’s not quite as sexy as talking about disease-modifying therapy, but it can be transformative for MS individuals.”

After many years, treatments for progressive forms of multiple sclerosis (MS) are finally starting to see some headway. The first approval for the progressive disease, ocrelizumab (Ocrevus), came in May 2017.

This has given Patricia Coyle, MD, an appreciation for the targeting of grey matter in progressive MS, as well as the presence of neurodegeneration at the earliest stages—highlighting a need for treatment to start early. 

Although, with all the focus on treating patients earlier and finally being able to treat those with progressive forms of the disease, there remains a need for symptom management. Coyle, the director of the Comprehensive Multiple Sclerosis Center at Stony Brook University sat with 

 to discuss how this can often be overlooked. Fatigue, tremor, spasticity, sleep disturbances, and many other issues that impact patients’ quality of life.

While it may not be as “sexy as talking about disease-modifying therapy,” as Coyle puts it, ensuring that patients’ everyday symptoms are being properly controlled and taken care of is still a priority for her. Particularly, patients with severe disease or preexisting disability can feel as though they are being left out with the focus having shifted to treating patients who are earliest in the disease course.

Ensuring patients quality of life is still being attended to is of utmost importance to the director of the Comprehensive Multiple Sclerosis Center at Stony Brook University.

Patricia Coyle, MD: Multiple Sclerosis Symptom Management

“I would like for people to be using an identical protocol.”

With a plethora of approved treatments and multiple highly efficacious disease-modifying therapies for multiple sclerosis (MS), it’s hard for the clinicians who treat the disease to ask for more. But as Patricia Coyle, MD, would say, that does not mean there aren’t plenty of needs that remain to be met.

Coyle, the director of the Comprehensive Multiple Sclerosis Center at Stony Brook Neuroscience Institute sat with NeurologyLive to discuss these needs. Specifically, she mentioned the need for informative biomarkers. While the collection of treatment for MS outpaces many other neurologic disorders, deciding on which therapy will be successful in which patient can be a staggering task. Biomarkers that could point to the efficacy of a therapy in a specific patient are of the utmost need. 

Additionally, those that could provide prognostic information that surpasses what can currently be done with magnetic resonance imaging are also at the top of Coyle’s list, right alongside a validated diagnostic biomarker.

Where there is the most room for improvement, though, is with imaging protocol. Currently, Coyle noted, insurance coverage can dictate too much of what could be beneficial to the patient. Without complete uniformity in the diagnostic criteria used, the patient suffers. For Coyle, standardization could result in leaps for the field.

The director of the Comprehensive Multiple Sclerosis Center at Stony Brook Neuroscience Institute discussed these needs.

Author | Patricia Coyle, MD

Articles

Global Approaches to the Management of Relapsing Multiple Sclerosis

Patricia Coyle, MD: Multiple Sclerosis Symptom Management

Patricia Coyle, MD: Needed Improvements in Multiple Sclerosis