Treatment Decisions With Stable MS


Negroski discussed some of the takeaways from an analysis of patients with stable MS who chose to switch from natalizumab to other, more moderate-efficacy oral disease-modifying therapies.

At the 2024 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, NeurologyLive sat down with MS expert Donald Negroski, MD, to discuss several of the top presentations and data on treatment switches and aging in MS. Negroski provided an overview of various presentations, offering his clinical perspective and how findings may impact care going forward.

In this conversation, Negroski detailed a study examining the clinical characteristics and treatment outcomes in those with stable multiple sclerosis treated with natalizumab who switched to moderate-efficacy oral disease-modifying therapies. The MS expert provided comment on what the data tells us about this patient group and the thought process behind choosing a different DMT for a patient who's condition has stabilized over time.

Transcript edited below for clarity.

Donald Negroski, MD: This abstract from Rush (Medical Center) is really interesting. They looked at one particular drug that is often used continuously in patients with MS, natalizumab, and used claims data, looking at patient resources, cost of health care, all that stuff. They kind of narrowed down those patients treated with natalizumab for extended period of time, they were clinically stable without relapses. These patients were then switched to either a fumarate or an S1P-modulating drug. So, those were the moderate oral agents. The investigators concluded, using claims data, that the number of relapses did not change when they switched treatments and the financial burden in terms of health care costs and patient encounters, or how many times patients contacted their health care provider, were unchanged as well. That drives home this concept of, what do you do with stable patients? Can you change to a different class of medication that works completely differently? I thought that that was pretty interesting.

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