June 2025

NEUROSCIENCES

NAVIGATING OPTIONS FOR MS: AN OVERVIEW OF DISEASE-MODIFYING THERAPIES

Featuring: ​Bruce Cohen, MD
​
Read time: 90 seconds

A recent publication from Bruce Cohen, MD, explores the evolving landscape of treatments for multiple sclerosis (MS), highlighting the importance of individualized approaches in selecting disease-modifying therapies (DMTs) to optimize patient outcomes.

​Challenges in MS Treatment Selection
  • Having many options creates complexity in choosing appropriate therapies
  • Factors that influence decision-making include:
    • Patients’ values, lifestyle and treatment goals
    • Disease characteristics such as severity, presentation type and progression risks
    • Medication attributes including efficacy, safety profiles and side effects

​Treatment Strategies
  • Escalation strategy: Start with a moderate efficacy DMT. Then switch to a higher-efficacy therapy if disease activity increases.
  • High-efficacy initial therapy: Start with a potent DMT to aggressively manage inflammation early. Evidence suggests this approach can reduce the risk of long-term disability progression.

Key Therapeutic Options
  • B-cell depleting agents:
    • Ocrelizumab and ublituximab: Highly effective with significant results in reducing relapse rates and disability progression
  • Other viable DMT options with different safety and efficacy profiles:
    • Teriflunomide 
    • Glatiramer acetate


Considerations for Patient Monitoring
  • Potential side effects include:
    • Higher risk of infections
    • Concerns related to immunosuppression
  • Special attention needed for:
    • Women of childbearing age
    • Patients with comorbid conditions

Future Directions
  • Initiating high-efficacy therapies whenever feasible to improve long-term outcomes.
  • Ongoing research will provide further insights into optimal treatment strategies.
  • Personalized medicine is key to ensuring the best possible patient care.
Read the full study>
File Size: 538 kb
File Type: pdf
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​Bruce Cohen, MD, Chief and Professor of MS/Neuroimmunology in the Department of Neurology

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