What are the key factors that you seek to uncover in order to land on the most effective DMT choice for patients with MS?

Key considerations are different depending on the age and stage of the disease. In the pediatric population, we consider age of the patient, vaccination status, and adherence (e.g., could the patient realistically maintain consistent daily oral medication, or would intermittent infusions be more opt...

I tend to start with high-efficacy therapy and thus will discuss the rationale for starting these early in the disease process, then will ask the patient what their preference is regarding the route of administration to pick a single DMT. Once on therapy, and after ensuring clinical efficacy with MR...

I generally consider three major domains when selecting a DMT: patient-specific factors, clinical disease characteristics, and radiographic disease characteristics.

From a disease perspective, I look for clinical and MRI features associated with a higher risk of future disability. For example, signi...

While generally the degree of activity (clinical and MRI lesion burden) is an important consideration in choosing DMT, the current landscape is such that the bulk of patients are either started on or switched to B-cell suppressor therapies. While there is minimal data on the utility of B-cell suppre...