“We don’t have an effective way to say this patient will responds to this drug, and that patient will respond to another drug, but what we do have is ways to stratify the risk of complications and aim patients towards one drug or another to minimize risk.”

Selecting an appropriate disease-modifying therapy for patients with MS requires taking into account several factors. While we don’t yet have enough evidence to know which particular patient will benefit exclusively from any single drug, a patient’s individual risk factors can help determine which therapy is most appropriate at that time.

In an interview with NeurologyLive, Robert Fox, MD, a neurologist at the Mellen Center for Multiple Sclerosis at Cleveland Clinic, reviewed the various considerations that should be taken into account when choosing an appropriate disease-modifying therapy. These include patients who have cardiovascular risk factors, those exposed to the JC virus, or those who have sensitive stomachs, for example. Fox also touched on the ongoing debate surrounding escalation-based therapy, or initiation on high-efficacy disease-modifying therapies.