Clinical Pearls for MS Management in Everyday Practice

EP: 1.Brain and Cognitive Changes in Multiple Sclerosis

EP: 2.Association Between Brain Volume and Long-term Cognition in Relapsing Multiple Sclerosis

EP: 3.Cognitive Care Recommendations

EP: 4.Factors Necessitating Treatment Change in Multiple Sclerosis

EP: 5.Ozanimod in DMT Naïve vs Experienced Patients with Relapsing Multiple Sclerosis

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EP: 6.Clinical Pearls for MS Management in Everyday Practice

EP: 7.Treatment Discontinuation in Multiple Sclerosis

EP: 8.Relapse Following Discontinuation of Ozanimod

EP: 9.Implications of Ozanimod Discontinuation Data for MS Care

EP: 10.Managing Relapses in Patients With Multiple Sclerosis

EP: 11.Long-Term Outcomes With Ozanimod Based on Number of MS Relapses

EP: 12.Advice for Clinical Management of Multiple Sclerosis

Gabrielle Macaron, MD: This study shows that ozanimod treatment is associated with positive outcomes on clinical and regenological measures of disease activity. This was seen in patients who were treatment naïve or in patients who were already on another disease-modifying therapy at baseline. This effect was maintained over the duration of the study period, which was 4 years. The clinical implication of this result is that patients with relapsing or remitting MS [multiple sclerosis] can benefit from ozanimod as a first- or second-line therapy. It’s important, however, to have a direct and long-term comparison of outcomes between these groups to see if treatment-naïve patients will benefit more in the long term. This would be in line with the first- line high-efficacy treatment approach in MS, which has been increasingly used in practice in the past few years.

In summary, significant recent data show that early treatment with a high-efficacy medication seems to be a good approach for many of our patients with MS, and delaying treatments is associated with poor outcomes in the long term, based on several recent studies evaluating this. My main advice is for every patient to always individualize treatment decisions based on the course and characteristics of the disease, such as the MRI lesion burden, the severity, and the frequency of relapses. It’s also based on patient characteristics: their age, family plans, and comorbidities but also their preferences. It takes into account the dynamic and continuous process of MS pathology throughout the life of a patient. Especially when we interpret data from randomized control trials, which aren’t necessarily generalizable to all our patients. When we pick a treatment according to randomized control trials, always think of the individual patient and how generalizable the data are and applicable they are and to our patients.

Transcript edited for clarity