Earlier provision of disease modifying therapies (DMTs) is now being advised for treatment of relapsing remitting multiple sclerosis.
This is part of a scientific consensus that changes the way treatment should be provided in the light of evidence that suggests that, rather than waiting to see whether more relapses occur, DMTs should be offered as close as possible to diagnosis, according to the MS Society in the UK
The change of approach is the result of the wider use of MRI scanning. This has provided evidence that when symptoms get better, the damage that MS causes often doesn’t stop. So even when someone with MS is not having a relapse, the disease may carry on attacking their body. This could lead to nerve damage that can’t be put right. Experts used to think that when a person with MS had a ‘relapse’ it meant symptoms appeared and/or quickly got worse and then went away or ‘remitted’. The evidence has changed what is understood about MS and how to treat it. Rather than waiting to see whether more relapses occur, DMTs should be offered as close as possible to diagnosis, before damage to the body has built up.
It is now known that early treatment improves long-term health and wellbeing by slowing down the build-up of irreversible damage and reducing the number of relapses people experience. However, the evidence doesn’t mean that starting treatment later will not have any benefits – it simply means ‘the earlier the better’.
The society says everyone with a relapsing form of MS should speak to their neurologist or MS professional about treatment options and make an active and informed choice about what is right for them.
For those who have a different form of MS, or aren’t sure what kind of MS they have, it’s still important to have an annual review with their neurologist although, in my experience, this is easier said than done. Anyone who doesn’t have a neurologist or MS specialist should visit their GP and request a referral.
The MS Society reached the new consensus with people affected by MS, neurologists, MS nurses, and the MS Trust. A meeting was held to consider the evidence about whether early treatment with DMTs improves long-term outcomes for people with MS. It was strongly agreed that the evidence confirms the importance of treating with DMTs as close to diagnosis as possible.
The recommendation follows the publication of new guidance from the Association of British Neurologists (ABN) and with support from Shift MS and MS Trust.