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“… the way of progress is neither swift nor easy.”
—Marie Curie
INTRODUCTION
An appreciation of the mechanisms of action (MoAs) of disease-modifying therapies for relapsing-remitting multiple sclerosis (RRMS) does matter in patient management. However, determining how MoAs matter at the clinical level continues to evolve along with our understanding of the pathogenesis of MS, the function of the nervous and immune systems, and the MoAs of current and newer agents. MS is a lifetime disease that may change and progress over time, requiring parallel changes in management.
As we contemplate the management options for RRMS and consider both established and emerging therapies, we need to determine how knowledge of MoAs affects clinical decision making. The key questions to ask are the following:
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Does understanding MoAs actually help in making treatment choices?
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How might understanding MoAs influence development of biomarkers of treatment response?
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Could understanding MoAs help understand side effects of MS therapies and/or how to prevent or treat such side effects?
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Could understanding MoAs help to develop newer therapies or to design combination and/or induction therapies?
SETTING UP THE MECHANISM IMPACT PARAMETERS
The questions to consider when weighing the contribution of the MoA of the agent to its role in disease and patient management are as follows:
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When there are multiple demonstrable MoAs in patients, in animal models, and in vitro, which are the most important for the therapeutic effect?
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Is it naïve to believe that there is only 1, or at least only 1 important, MoA for each agent?
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Could different MoAs become important at duration of treatment?
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Could different MoAs be important in different lesions in RRMS?
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Could different MoAs become important at different stages of disease and as pathologic lesions evolve?
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Are the MoAs that are important for therapeutic effects the same MoAs that are responsible for significant side effects and complications?
Based …
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You May Also be Interested in
- Article
- INTRODUCTION
- SETTING UP THE MECHANISM IMPACT PARAMETERS
- UNDERSTANDING MoA IN MAKING TREATMENT CHOICES: DOES UNDERSTANDING MoA HELP IN MAKING TREATMENT DECISIONS?
- MoAs AND BIOMARKERS: DOES UNDERSTANDING MoAs INFLUENCE DEVELOPMENT OF BIOMARKERS FOR TREATMENT RESPONSE?
- MoAs AND SIDE EFFECTS: COULD UNDERSTANDING MoAs REVEAL MECHANISMS OF SIDE EFFECTS AND HOW TO TREAT, PREVENT, OR LIMIT SIDE EFFECTS?
- MoAs AND COMBINATION THERAPIES: WOULD UNDERSTANDING MoAs HELP DESIGN COMBINATION THERAPIES?
- CONCLUSIONS
- DISCLOSURE
- Footnotes
- Info & Disclosures
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