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Why Do We Switch Treatments for Multiple Sclerosis?
Published: Jul 31, 2024
Multiple sclerosis (MS) is a tricky condition to manage, often requiring changes in treatment. Let's explore why switching treatments might be necessary and what it involves.
Understanding the Need for Change
Sometimes, MS treatments, known as disease-modifying therapies (DMTs), don't work as well as they should. If a person experiences serious relapses or new lesions on MRI scans after being on a treatment for a while, it might be time to consider other options. The American Academy of Neurology suggests switching if there's no improvement over a year, especially with multiple relapses or worsening disability.
When to Reconsider Diagnosis
Occasionally, what looks like MS progression might actually be something else. If symptoms worsen despite high-efficacy DMTs, doctors may reassess the diagnosis. Conditions like neuromyelitis optica can mimic MS but require different treatments. Recognizing 'pseudorelapses,' where symptoms temporarily worsen due to factors like fever, is also vital.
Monitoring MS Activity
Doctors use various scoring systems to track MS activity and treatment effectiveness. The Rio and modified Rio scores help predict outcomes based on relapses and MRI changes. NEDA, or No Evidence of Disease Activity, is another benchmark aiming for no relapses or new brain lesions.
Frequently Asked Questions
Switching is considered when current treatments aren't effective.
It's a temporary worsening of symptoms not due to a true relapse.
No Evidence of Disease Activity.
The Bottom Line
Switching MS treatments is a complex decision requiring careful evaluation.
References
- Sormani MP, Gasperini C, Romeo M, et al. Assessing response to interferon-β in a multicenter dataset of patients with MS. Neurology 2016; 87:134.
- Sormani M, Signori A, Stromillo M, De Stefano N. Refining response to treatment as defined by the Modified Rio Score. Mult Scler 2013; 19:1246.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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