Customizing Treatment Approaches With High Efficacy Therapies

Opinion
Video

Ahmed Obeidat, MD, PhD, Riley Bove, MD, Stephen Krieger, MD, and Erin Longbrake, MD, PhD, discuss the definition of high-efficacy therapy and its place in MS care.

This is a video synopsis/summary of a panel discussion involving Ahmed Obeidat, MD, PhD; Riley Bove, MD; Stephen Krieger, MD; and Erin Longbrake, MD, PhD.

The conversation revolves around the classification and efficacy of medications used in the treatment of multiple sclerosis (MS). The participants discuss 2 ongoing pragmatic trials: TREAT-MS and DELIVER-MS, which aim to compare different treatment approaches through randomization.

One participant shares their perspective on these trials, emphasizing the importance of objective evidence to support the early aggressive treatment approach in MS. They believe that starting treatment early with more effective therapies can lead to better outcomes, as delaying treatment can result in long-term complications.

In terms of medication efficacy, the participant categorizes medications into high, medium, and traditional efficacy tiers. High-efficacy medications include anti-CD20 therapy, S1P receptor modulators, and cladribine. On the other hand, first-line self-injectable therapies like interferons and glatiramer acetate are considered to be on the lower end of efficacy.

The efficacy of teriflunomide, an oral medication, remains ambiguous. While it was initially considered modestly effective compared to older injectable interferons, recent trial data suggests varying efficacy levels when compared to newer medications like ocrelizumab, ublituximab, and evobrutinib.

There is uncertainty regarding where to place teriflunomide in the current spectrum of MS treatments. Despite its inconsistent efficacy in trials against newer agents, it remains a viable treatment option with potential benefits.

The participants also discuss whether clinical trials are designed to favor teriflunomide. One participant suggests that trials are not intentionally designed to make teriflunomide appear more effective but acknowledges the challenges in determining its exact place in MS treatment protocols.

Video synopsis is AI-generated and reviewed by NeurologyLive editorial staff.

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