Peers & Perspectives: The Induction vs Escalation Approach to MS and the TREAT-MS Trial


Scott Newsome, DO, and Ellen Mowry, MD, discuss the ongoing TREAT-MS trial and its goals, the importance of the findings for clinical practice in multiple sclerosis, and the ongoing discussion around induction vs escalation in MS treatment. [WATCH TIME: 24 minutes]

WATCH TIME: 24 minutes

Discussion Breakdown

00:05 – Introductions

00:50 – Most exciting aspects of TREAT-MS

03:30 – Observational vs prospective data on MS treatments

07:30 – Background on the biobanking substudy

08:30 – COVID-19 and multiple sclerosis, and COVID-19 substudy

11:55 – Secondary end points and outcomes

16:50 – Goals for the diversity of enrollment and participating sites

20:10 – Final thoughts

For years now, the discussion and debate about utilizing the induction or the escalation approach for patients with multiple sclerosis (MS) have raged on. Literature has pointed to the benefits of both methods, and many clinicians admit that treating MS does not result in a one-size-fits-all approach. There are, however, a pair of clinical trials—TREAT-MS (NCT03500328) and DELIVER-MS (NCT03535298)—currently ongoing that are aimed at answering this very question. The trials parallel one another and seek to enroll a total of more than 1700 individuals between them.

TREAT-MS is a pragmatic trial with a primary outcome of disability progression measured by EDSS plus, a compound outcome of the 9-Hole Peg Test and Timed 25-Foot Walk Scores alongside EDSS measures. DELIVER-MS, being conducted in both the US and the UK, is parallel in its main outcomes, with secondary measures including patient-reported disability, the impact of disease, health-related quality of life, relapse recovery, imaging outcomes, clinical performance metrics, social status, and safety.

At the Consortium of MS Centers Annual Meeting in June, two of the physicians involved in the trial, Scott Newsome, DO, associate professor of neurology, Johns Hopkins School of Medicine, and Ellen Mowry, DO, professor of neurology and epidemiology, Johns Hopkins School of Medicine, sat down together to discuss these efforts at length, and share some perspectives on their importance to clinical practice.

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