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Dr. Gavin Giovannoni recently presented at an annual meeting for ECTRIMS, the world’s largest professional organization dedicated to understanding and treating multiple sclerosis (MS).1 In this presentation, he discusses the benefits of starting MS patients early on high-efficacy, disease-modifying therapies (DMTs), including improved brain health.2
This is an opinion of a physician based on clinical experience. Treatment results may vary for individual patients. Your doctor will be able to advise you on the appropriate treatment plan.
DID YOU KNOW?
The introduction of DMTs, a type of medication that works on the immune system to reduce inflammation caused by MS, has played an important role in maximizing brain health for MS patients.
There are a lot of considerations when choosing an appropriate DMT. Some important factors a doctor will consider when deciding on a treatment are2:
- disease severity,
- treatment safety,
- patient’s own needs like family plans,
- patient’s aversion to risks.
In addition, doctors often navigate the balance between treatment response and treatment failure when selecting a therapy.2 But how do doctors figure out that a specific treatment will achieve treatment response?
Well, this is where treatment strategy comes into play.2
What are Treatment Strategies in MS?
Currently, it’s not possible to predict whether a patient will respond well to a particular DMT. However, the odds of a patient responding to a treatment can be increased by starting them on a high-efficacy DMT.2
When you move from starting on low-efficacy therapy to a high-efficacy therapyearly in your treatment journey,
Dr. Giovannoni estimates success of response rate increases2:
20%
80%
This treatment strategy, whereby patients are started on a high-efficacy therapy following diagnosis is known as “flipping the pyramid” since it’s opposite to the typical treatment strategy of starting off with a low-efficacy DMT and escalating to a high-efficacy therapy when there is a breakthrough disease activity.2
Talk to your doctor if you have more questions about high-efficacy DMTs and if it’s an appropriate treatment option for you
What are your treatment goals?
You may have heard or discussed with your doctor that your treatment goals should focus alone on eliminating disease activity. But should treatments do more than that? Dr. Giovannoni thinks that the ultimate goal of MS treatments should be to “maximize brain health so patients can age normally.”2
To achieve this goal, he believes patients should2:
- have rapid access to diagnosis,
- have rapid access to a DMT,
- receive early escalation to a high-efficacy DMT,
- and adopt positive lifestyle changes (e.g., nutrition, exercise, proper sleep, hygiene).
Check your knowledge!
What did you learn?
True or false?
Diagnosing and treating MS are the only considerations needed when trying to achieve good brain health.
True! Maximizing brain health may be possible through rapid access to diagnosis, rapid access to a DMT, and early escalation to a high-efficacy DMT. In addition to this, patients should also adopt positive lifestyle changes to improve their health outcomes.2
When considering your treatment options, you should discuss disability outcomes with your doctor.
Not true! Maximizing brain health may be possible through rapid access to diagnosis, rapid access to a DMT, and early escalation to a high-efficacy DMT. In addition to this, patients should also adopt positive lifestyle changes to improve their health outcomes.2
References:
1. ECTRIMS. About ECTRIMS. Available online at https://www.ectrims.eu/about-ectrims/. Accessed July 2023.
2. Giovannoni G. Flipping the pyramid and beyond ECTRIMS 2022. October 2022. Available online at https://www.youtube.com/watch?v=DEm8pys6zH0. Accessed April 2023.
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