Emphasizing Shared Decision Making and Emerging Strategies in MS Treatment: Patricia K. Coyle, MD

WATCH TIME: 3 minutes

“If you have a patient with MS starting a great treatment but they're smoking, they're overweight, they don't exercise, they sleep poorly, then they are sabotaging getting the best therapeutic response. It's important that the patient be knowledgeable about that and try to work through it with them as that's extremely important. It's a conversation that I have with every one of my patients with MS on an early basis.”

A shared decision-making approach has been shown to be an effective way to improve the lives and outcomes of patients with neurologic disorders. This type of approach has been implemented in multiple sclerosis, a central nervous system (CNS) disease, at various points throughout the course of the disease.¹ According to a study published in the International Journal of MS Care, findings suggest that shared decision-making interventions can have a beneficial effect on patient adherence to disease-modifying therapies in MS care.² Over the last decade, recent studies on patient education and outcomes of shared decision aids have increased in the field of MS for clinicians and their patients.

Despite the progress made in MS treatments, some are associated with adverse events related partly due to their route of administration and some have limitations because of rapid clearance and an inability to reach the CNS. The delivery of therapeutics to the CNS is mainly limited because of the presence of the blood-brain barrier. In recently published study, researchers noted that there is a need to develop new therapy delivery strategies to ensure CNS availability and capitalize on identified therapeutic targets.³

At the 2023 International Congress on the Future of Neurology (IFN) Annual Meeting, held September 22-23, in Jersey City, New Jersey, Patricia K. Coyle, MD, had a talk on recent updates in the field of MS. During the meeting, Coyle sat down in an interview with NeurologyLive® to discuss how shared decision making empowers patients with MS in guiding their treatment goals. She also talked about why addressing lifestyle factors is important in optimizing therapeutic responses for patients. Additionally, Coyle, professor of neurology at Stony Brook University Medical Center, spoke about the key developments and timelines expected in CNS repair strategies for neurological diseases, including MS.

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REFERENCES
1. Colligan E, Metzler A, Tiryaki E. Shared decision-making in multiple sclerosis. Mult Scler. 2017;23(2):185-190. doi:10.1177/1352458516671204
2. Ben-Zacharia A, Adamson M, Boyd A, et al. Impact of Shared Decision Making on Disease-Modifying Drug Adherence in Multiple Sclerosis. Int J MS Care. 2018;20(6):287-297. doi:10.7224/1537-2073.2017-070
3. Mwema A, Muccioli GG, des Rieux A. Innovative drug delivery strategies to the CNS for the treatment of multiple sclerosis. J Control Release. 2023;364:435-457. doi:10.1016/j.jconrel.2023.10.052