High-Efficacy Disease-Modifying Therapies for Multiple Sclerosis

Jason Freeman, MD, MBA: Joining us today from ACTRIMS is Dr Abby Rogers, a Medical Science Liaison with Novartis Pharmaceuticals. Welcome, Abby.

Abby Rogers, DMSc, PA-C, MPAS: Thanks, Jason.

Jason Freeman, MD, MBA: So, Abby, can you tell me what the rationale is for early initiation of high-efficacy DMTs and treatment-naive patients with RRMS?

Abby Rogers, DMSc, PA-C, MPAS: Absolutely. So, early intervention in the disease of MS can really alter the disease course for patients. So delaying DMTs, even for a number of years, can really lead to a decrease in cumulative efficacy. So, for patients that are started on escalation therapies versus high-efficacy therapies, there is really a gap that is there for patients. They're unable to catch up to those that are on high-efficacy therapy. They accumulate disability at a faster rate. They have higher, we know that in the disease course of MS, there are higher amount of relapses early on in the disease. And that's where we really want to really target patients so that they can be on a high-efficacy therapy earlier because they can't gain that disability back.

Jason Freeman, MD, MBA: And discuss with us a little bit the study design and how many patients were treated and what they were actually evaluating in this study.

Abby Rogers, DMSc, PA-C, MPAS: Absolutely. So this was a national registry that came from Kuwait, and this was a cross-sectional study using 123 treatment-naive relapsing-remitting MS patients. And they looked at 3 high-efficacy therapies. They wanted to follow these patients over the course of 1 year and look at adverse events relapse rates, as well as NEDA-3.

Abby Rogers, DMSc, PA-C, MPAS: And they saw that across the board. These patients reported a similar proportion of adverse events, and as well, they were similar in efficacy as far as reaching NEDA-3 over that course of time. And a higher proportion of patients across the board were free from relapses.

Jason Freeman, MD, MBA: So, when you talk about efficacy, what does that mean, especially as we look at this study and, and see these things in treatment-naive patients?

Abby Rogers, DMSc, PA-C, MPAS: Some clinicians say I want to use high-efficacy therapy treatment, but what is it for my patients? And so when we look at a study like this, it is able to showcase that across these 3 high-efficacy treatments, patients they're free from relapse. They're free from, say in this study particularly higher number of patients we're talking 80% or higher are NEDA-3 free. They're able to meet these end points.

Jason Freeman, MD, MBA: So, your takeaway from high-efficacy therapy treatment-naive patients. What do you want to tell our audience?

Abby Rogers, DMSc, PA-C, MPAS: I think there's a higher number of relapses that happen early in the disease. And so, this is really the key to starting them early on treatment that's highly efficacious.

Jason Freeman, MD, MBA: Thank you.

Abby Rogers, DMSc, PA-C, MPAS: You're welcome.

Transcript Edited for Clarity