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Treatment Optimization in Multiple Sclerosis*

Published online by Cambridge University Press:  16 February 2016

Mark S. Freedman ,
David G. Patry ,
François Grand'Maison ,
Mary Lou Myles ,
Donald W. Paty  and
Daniel H. Selchen
Mark S. Freedman*
Affiliation:
MS Research Clinic, University of Ottawa, Ottawa Hospital General Campus, Ottawa, Ontario, Canada
David G. Patry
Affiliation:
MS Clinic, Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
François Grand'Maison
Affiliation:
Division of Neurology, University of Sherbrooke, Hôpital Charles LeMoyne, Longueuil, Quebec, Canada
Mary Lou Myles
Affiliation:
University of Alberta, Edmonton, Alberta, Canada
Donald W. Paty
Affiliation:
Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Daniel H. Selchen
Affiliation:
University of Toronto, Trillium Health Centre-Mississauga, St. Michael's Hospital, Toronto, Ontario, Canada
*
Professor of Medicine (Neurology), University of Ottawa, Director, Multiple Sclerosis Research Clinic, The Ottawa Hospital-General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
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Abstract

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The treatment of multiple sclerosis has finally become possible with the advent of the current disease-modifying therapies (DMTs) that have had a significant impact on those living with this disease. Though demonstrating clear efficacy on a number of short-term outcome measures, unfortunately, these agents are not “cures” and many patients with multiple sclerosis continue to experience disease activity in spite of treatment. Clinicians are becoming more comfortable initiating therapy with DMTs, but it is now important to focus attention on monitoring the results of the chosen therapy and deciding whether or not a patient is responding well to treatment. At present, however, clinicians lack criteria for defining optimal versus suboptimal responses to DMTs as well as evidence-based guidelines on how to improve treatment outcomes. Using a recently published model as a framework, The Canadian Multiple Sclerosis Working Group developed practical recommendations on how neurologists can assess the status of patients on DMTs and decide when it may be necessary to modify treatment in order to optimize outcomes. The Canadian Multiple Sclerosis Working Group's recommendations are based on monitoring relapses, neurological progression and MRI activity. Other possible causes of suboptimal treatment responses or treatment failure are also considered.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 2 , May 2004 , pp. 157 - 168
Copyright
Copyright © The Canadian Journal of Neurological 2004

Footnotes

*

Recommendations from The Canadian Multiple Sclerosis Working Group

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