Prescribing DMT in Radiologically Isolated Syndrome: Ilena George, MD


The neurologist from Massachusetts General Hospital discussed physician rationales behind prescribing DMT use in RIS.

“Reasons to initiated disease-modifying therapy included change on MRI and a high burden of disease on MRI. And also, even though it wasn't explicitly stated, it did seem as though people who had greater risk factors were the ones who are more likely to be treated as well.”

A recent study found that patients with radiologically isolated syndrome (RIS), often a precursor for multiple sclerosis (MS) are being prescribed disease modifying therapy (DMT) at higher rates than previously seen. The study data was presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021, February 25-27, by Ilena George, MD, neurologist, Massachusetts General Hospital, and colleagues.

George and colleagues investigated physician rationales for DMT prescription. The most common rationale was magnetic resonance imaging (MRI) change over time including newly gadolinium-enhancing lesions, reported by doctors in 13 cases (65%). Other reasons included clinical suspicion for a high risk of conversion to MS, reported in 6 cases (30%), and/or a high burden of central nervous system demyelinating disease on MRI, reported in 4 cases (20%).

NeurologyLive spoke with George to learn more about the prevalence of DMT prescription in RIS. She shared her perspective about the benefits and risks of prescribing DMTs to individuals with RIS.

For more coverage of ACTRIMS Forum 2021, click here.

George IC, Rice DR, Chibnik L, Mateen FJ. Prevalence and use of disease modifying therapy in radiologically isolated syndrome (RIS): A retrospective study. Presented at ACTRIMS Annual Forum; February 25-27, 2021. Poster P168.
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