Fast Five Quiz: Key Aspects of Multiple Sclerosis Treatment

Michelle H. Cameron, MD, PT, MCR


December 06, 2018

Clinicians should counsel patients with MS who are considering discontinuing natalizumab that doing so is associated with an increased risk for relapse or MRI-detected disease activity within 6 months. Patients with MS who are taking natalizumab may choose to discontinue treatment with that drug due to fear of risk for progressive multifocal leukoencephalopathy (PML) or for pregnancy planning.

Multiple studies of DMTs in patients with relapsing MS who have had recent relapse, MRI activity, or both have shown benefits from DMT treatment. This includes patients with a single clinical episode who meet the 2010 international criteria for MS. Clinicians should offer DMTs to patients with relapsing forms of MS with recent clinical relapse or MRI activity. However, many people who receive major diagnoses do not remember much of the information they receive immediately after diagnosis. A dedicated treatment visit is advised for discussion of DMT options in patients with newly diagnosed MS.

DMTs reduce MS relapses and MRI activity, but they do not eliminate them. Patients should be educated to ensure realistic expectations. DMTs are not indicated for relief of symptoms, so additional treatment may be required. Patients should also be counseled to notify clinicians if symptoms worsen.

DMTs have varying degrees of potential risk in pregnancy. Discussing the possibility of pregnancy with women with MS before initiating DMT is important. For women who are planning to become pregnant soon, DMT decisions may be influenced by pregnancy plans.

Read more about DMT in MS here.


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