Balancing MS Relapse Risk With Personalized Therapy Decisions: Gabrielle Macaron, MD

WATCH TIME: 4 minutes

"I think patient support programs from pharmaceutical companies can be really helpful in making sure that at least the pretreatment workup and the ongoing monitoring is going as expected and that nothing falls through the cracks.”

Multiple sclerosis (MS) is considered one of the primary causes of nontraumatic neurological disability in young adult patients. Clinicians have advised early use of disease-modifying therapies (DMTs), along with consistent monitoring, for patients who are living with relapsing-remitting forms of the disease. Postponing treatment following a diagnosis could potentially lead to greater disease burden and increased societal health care costs. A wide range of DMT options are available for patients, which differ in administration method, efficacy, adverse effects, safety considerations, as well as cost.

According to a previous study published in Patient Preference and Adherence, researchers reported that the most significant factor in choosing a DMT was its adverse effect profile, followed by its ability to delay disability progression. Findings also showed that patients' treatment preferences evolved based on their prior experiences with DMTs and the length of time since their diagnosis. The findings highlighted the importance of developing and selecting therapies that reflect patient preferences, which may lead to improved adherence and more effective long-term management of MS.¹

At the 2025 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 28-31, 2025, in Phoenix, Arizona, Gabrielle Macaron, MD, gave a talk on the initial decision-making process for what DMT patients should start. During the meeting, Macaron, an assistant professor in the Department of Neuroscience at Université de Montréal, sat down with NeurologyLive^® to outline the dual risks of MS and its DMTs. In the interview, she highlighted the unpredictable nature of the disease and the value of early, high-efficacy treatment to reduce long-term disability, as well as discussed risk mitigation strategies and adapting treatment choices to patient lifestyles and preferences.

Click here for more coverage of CMSC 2025.

REFERENCES
1. Bansback N, Chiu JA, Metcalfe R, et al. Preliminary testing of a patient decision aid for patients with relapsing-remitting multiple sclerosis. Mult Scler J Exp Transl Clin. 2021;7(3):20552173211029966. Published 2021 Jul 15. doi:10.1177/20552173211029966
2. Garcia-Dominguez JM, Muñoz D, Comellas M, Gonzalbo I, Lizán L, Polanco Sánchez C. Patient preferences for treatment of multiple sclerosis with disease-modifying therapies: a discrete choice experiment. Patient Prefer Adherence. 2016;10:1945-1956. Published 2016 Sep 26. doi:10.2147/PPA.S114619
3. Macaron G. Decision Making Process Around What DMT to Start. Presented at: 2025 CMSC Annual Meeting; May 28-31; Phoenix, AZ. Era of Too Many Choices: Starting and Switching. 2016;10:1945-1956. Published 2016 Sep 26. doi:10.2147/PPA.S114619