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Treatment options in multiple sclerosis (MS) have expanded tremendously, with 23 disease-modifying therapies (DMT) approved in the United States since 1993. Along with the increasing number of approved MS DMTs, refinements to diagnostic criteria and recognition of the benefits of early treatment have led clinicians to diagnose and treat patients when they have a first demyelinating episode. Furthermore, treatment approaches have shifted to the use of more powerful, highly efficacious agents, including monoclonal antibodies (mAbs), at onset.1 The newer therapies, such as natalizumab, alemtuzumab, and the anti-B-cell mAb ocrelizumab, have made “no evidence of disease activity” a realistic therapeutic target, delayed the onset of progressive disease, and led to improved quality of life of individuals with MS. Yet these agents are a double-edged sword: with higher efficacy comes potential risks, particularly with long-term use of these therapies.2
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
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