Sequencing Disease-Modifying Therapies in Multiple Sclerosis
Stephen Krieger, MD; Daniel Bandari, MD, MS; Bruce Hughes, MD; Mitzi Williams, MD; and Heidi Crayton, MD, share their thoughts on sequencing disease-modifying therapies when treating patients with multiple sclerosis.
Stephen Krieger, MD: Well, it’s a good segue into thinking about sequencing medicines. Generally speaking, when I’m starting a patient on an MS [multiple sclerosis] therapy for the first time, I say, “I want to make the best decision we can. A decision that is right for now and maybe right for the long-term.” But someone doesn’t need to think that when they’re starting an MS medicine at age 32, that they’re going to have to be on that drug for the next 50 years. We realize that the field moves, things get better, and we have options that we didn’t have before. I think it’s worth thinking about sequencing in the grand scheme. Dr Bandari, I know you’ve looked at some recent publications on how patients are being started on and changing medicines. What did those publications say? What surprised you?