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Contemporary trends in treatment of multiple sclerosis (MS) have embraced the concept “time is brain” to emphasize the importance of utilizing disease-modifying treatments for MS to mitigate irreversible and usually silent damage to axons in early phases of the disease that may result in later progressive axonal degeneration with consequent disability. Recommendations that have emerged from this construct are the need for early treatment,1 possibly with potent therapies (“induction treatment”),2 with strict assessment and rigorous requirements for efficacy (“no evidence of disease activity”)3 to achieve better outcomes. Similar approaches are now espoused in other autoimmune diseases in which acute flares ultimately lead to chronic destructive disease, such as rheumatoid arthritis.4
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- © 2016 American Academy of Neurology
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