Personalized Use of Disease-Modifying Therapies in Multiple Sclerosis

TL;DR

This paper reviews how to personalize disease-modifying therapies for multiple sclerosis patients based on individual factors and shared decision-making.

Contribution

The paper provides an updated review on personalizing DMT use in relapsing MS patients through shared decision-making.

Findings

More than ten disease-modifying drugs are now available for multiple sclerosis.

DMTs vary in efficacy, administration routes, and risks, requiring careful personalized use.

Shared decision-making is advocated to align with patient preferences and understanding of DMT benefits and risks.

Abstract

Multiple sclerosis is an important neurological disease affecting millions of young patients globally. It is encouraging that more than ten disease-modifying drugs became available for use in the past two decades. These disease-modifying therapies (DMTs) have different levels of efficacy, routes of administration, adverse effect profiles and concerns for pregnancy. Much knowledge and caution are needed for their appropriate use in MS patients who are heterogeneous in clinical features and severity, lesion load on magnetic resonance imaging and response to DMT. We aim for an updated review of the concept of personalization in the use of DMT for relapsing MS patients. Shared decision making with consideration for the preference and expectation of patients who understand the potential efficacy/benefits and risks of DMT is advocated.