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Choosing Therapies for Patients With MS: Devon Conway, MD

The staff neurologist in the Neurological Institute’s Mellen Center for Multiple Sclerosis Treatment and Research at Cleveland Clinic outlined the process of choosing a therapy for patients with multiple sclerosis. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

“When I first started, I used to go through every single option that we had—and that didn't take too much time—but now, that's not really practical. I do like to give the patient a choice and make them aware that there are choices…I try to narrow things down to maybe a couple of different options and discuss those with the patient to get their take—I think having their input and trying to engage them as an active member of the team is really important.”

Although the market for multiple sclerosis (MS) treatments has recently been described as “crowded,” there are additional benefits to having different options to choose from. Devon Conway, MD, staff neurologist, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, spoke with NeurologyLive® on the state of the market in MS, also discussing his process for selecting treatments for individual patients. 

Conway noted the importance of incorporating patients’ input when choosing a therapy. This can be vital for women with MS, as the disease can present challenges during childbearing years, he said, making it necessary to determine whether certain treatments with be compatible with pregnancy, if having a child is something on the patient is considering. 

When asked about the multitude of treatments for MS, Conway highlighted the fact that clinicians can now switch patients from medications that are in the same class, if that patient is not tolerating a particular treatment but does not want to abandon that mechanism of action. This is noteworthy within the fumarate class, as dimethyl fumarate has a new iteration in the form of diroximel fumarate, which was developed to reduce gastrointestinal side effects. For patients with breakthrough forms of MS, however, it is convenient to have additional classes available, such as cladribine (Mavenclad; EMD Serono), Bruton tyrosine kinase inhibitors, and the newly approved anti-CD20 treatments, Conway said. 

For more coverage the Institutional Perspectives in Neurology: Multiple Sclerosis events, click here.