Should More Disabled Multiple Sclerosis Patients Stop Their Disease-Modifying Drug?

A minority of MS experts believe that patients with higher disability from secondary progressive Multiple Sclerosis will not respond to a disease-modifying drug and thus do not need to be treated. There is a “window of opportunity” to diagnose MS as early as possible, treat it appropriately, and reduce the risk of this occurring. But what to do when patients begin to accumulate disability and move from an Expanded Disability Status Scale (EDSS) of 3 to 4 and then 6? A score of 6 means that an assistive device, such as a cane, is needed and that the walking distance is reduced. Patients may take 20 years or may never reach an EDSS score of 3, but once they do, they tend to move rapidly from 3 to 4 and then to 6.

A new study presented at ACTRIMS 2016 Forum has concluded that in this patient group, using a “higher-efficacy immunomodulatory therapy” leads to reduced risk of accumulating further disability.

According to the lead author, Dr Nathaniel Lizak, “these observations justify treatment even after moderately advanced disability has been attained.”

See Neurology Reviews, April 2016.

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