When it comes to initial treatment selection for relapsing-remitting multiple sclerosis (RRMS), there is one question that has yet to be answered: Is it better to start with potentially safer moderately effective disease-modifying treatments (DMTs) or to hit the disease immediately with a high-efficacy DMT that may be more effective but carries more risks?
In a recent opinion article published in the journal Lancet Neurology, Daniel Ontaneda, MD , CTSC KL2 Scholar grad and neurologist at the Cleveland Clinic, addressed the controversies surrounding early treatment selection for people with RRMS, stressing the variability of initial treatment selection and the weak existing data that guides those choices.
To decide which treatment to start with, doctors use “a combination of MRI, clinical characteristics, and how much risk the patient is willing to take, and we make a decision based on all those factors,” Ontaneda explained.