Factors Necessitating Treatment Change in Multiple Sclerosis
A multiple sclerosis expert, Dr Gabrielle Macaron, discusses factors that can lead to a change of therapy for patients with multiple sclerosis.
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
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: What factors lead to a change of disease-modifying therapy? In a nutshell, the answer is that patients with relapsing/remitting multiple sclerosis [MS] typically stay on their treatment if it’s working. Higher-efficacy disease-modifying therapies work better for most patients, and we typically don’t need to switch patients who are on this category of treatment based on efficacy. In practice, treatment response and efficacy are measured based on the presence or absence of clinical relapses; a worsening physical disability, which is most commonly measured by the EDSS [Expanded Disability Status Scale]; and new or enhancing lesions on follow-up MRIs. These 3 key criteria are grouped in a composite outcome measure, which is called NEDA, or no evidence of disease activity, which is commonly used in clinical research and practice. But defining treatment response isn’t as straightforward and several other factors might be necessary to take into account or take into consideration before we can decide if a patient should stay on a treatment or switch treatments. This area of the MS field is still a gray zone, and we don’t exactly know what factors are the most predictive of long-term positive treatment response.
Transcript edited for clarity
