welcome
by
disease
management
how to guide
treatment decisions
Today´s MS Patient
A complete transformation of the MS landscape
Milder disease & treated earliers
Positive impact on cognitive impairment
our
understanding
of MS
has evolved
over time
population is changing
ms patients
are treated
earlier
diagnostic
criteria
has evolved
more
advanced guidelines
there are
a lot of
new
treatments
MRI can detect
subclinical
disease activity
we need to monitore
challenges
cost
identify those patients
with low response
lack of
reproducibility
high technical
expertise
who have decrease
new cortical lesions
Role of DMDs in delaying disability progression
by
reduction
in relapses
over long term
progression
is limited in
moderm population
early treatment is
essential
treat early
treat the patients
as early as possible
mantain
patient
quality
of life
is the key goal
delay disability
over long term
therapeutic mechanisms impact the immune system
bysafety
considerations with MS therapies are linked to the very mechanisms that mediate their beneficial effects
Monitoring
requirements
vary between
treatments
Patient
and clinical
trial
experience
efficacy against potential side effects
safety benefit
efficacy risk
the risk balance
balancing safety & efficacy
guiding treatment decisions
Pregnancy is key
consideration for
patients when
determine the
appropiate
treatment therapies
Breastfeeding
is an
important
consideration
appropriate treatment
switching
why
how
consider balance
between
efficacy and safety
it´s important
to consider
the prognostic
of the disease
depends on
the risk
of the patient
non
responders patient
we need some study
me need some data
what is treatment failure?
treatment de-scalation
- scenarios -
there is a lack of consense - guidelines
look at the evidence
patients
who are
considenring
pregnancy
safety
and
TOLERABILITY
issues
benefits
vs
risk
lack
of
efficacy
there is a safety concern
efficacy
proven
early impact
Beneficial effect
maintained with
long term treatment
patients should
be encourage
undertake lifestyle
changes to help
manage cognitive
symptoms
significantly
reduces new gd
+
lesions in early
disease
8/10
patient did not
need walking aid
reduce
MRI burden
of disease
reduced the risk of
disability progression
in RRMS versus
delayed treatment
making decisions
based on the need to
balance
safety and efficacy
Panel discussion
there is
always a way
to make your
experience
better
it is a
pragmatic
approach
the concept
reconstitution
of the immune
system
tolerability
to drugs
how to reach
the goal?
consider the activity of the patient
