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AAN 2020: Multiple Sclerosis Treatment Considerations - Episode 9

The Future of Multiple Sclerosis Management

Ravi Dukkipati, MD: This is an exciting time. This is an exciting time for multiple sclerosis. We’ve gone from having a handful of disease-modifying therapies to well over 15, 16, perhaps 17 therapies available. Looking in the near future as well as long term, there are several exciting drugs in the pipeline. Some represent perhaps updated versions of current drugs in terms of method of action. There are some new drugs being developed with new methods of action or different mechanisms of action. They may represent an option hopefully for areas of MS [multiple sclerosis] that we continue to experience challenges in treating—active secondarily progressive patients, primary progressive MS patients, etc.

During this COVID-19 [coronavirus disease 2019] era, some have been more risk averse. Although we should all exercise judicious caution, I don’t think we are doing our patients any favors by withholding treatment. One has to weigh the relative risks of suboptimally treated multiple sclerosis against the risk of contracting COVID-19. I have settled on utilizing the best treatment for a patient while balancing that with discussion about COVID-19 safety. In other words, for the most part I’m not withholding the best treatment option for patient because of COVID-19.

To summarize, I would say MS is a chronic disease state that requires ongoing treatment, not only disease-modifying therapy but also symptomatic therapies and lifestyle therapies. We must maintain vigilance even during this COVID-19 era and not ignore the needs of patients.