The Role of High-Efficacy Therapies in Multiple Sclerosis Treatment: Patricia K. Coyle, MD

WATCH TIME: 4 minutes

"I think you also need to educate the individual with MS, and there is accumulating data suggesting that the best ‘bang for the buck’ in using a high-efficacy agent is to use it early as the initial therapy in treatment-naïve individuals. That approach seems to have the greatest impact on avoiding the development of disability years later.”

High-efficacy disease-modifying therapies (DMTs) have become pivotal in the management of multiple sclerosis (MS), particularly when initiated early in the disease course. Recent studies have indicated that starting treatment with high-efficacy DMTs could significantly reduce the risk of disability progression and relapse rates compared with moderate-efficacy therapies. Research also has shown that patients who begin treatment with these agents have a lower probability of experiencing 6-month confirmed disability worsening and relapses.¹ These findings highlight the need for early and strategic therapeutic interventions to improve long-term outcomes for individuals with MS.

Recognizing this critical need, experts gathered at symposium during the 2025 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, held February 27 to March 1, in West Palm Beach, Florida. Led by Gavin Giovannoni, MBBCh, PhD, with presentations from Patricia K. Coyle, MD, and Mark S. Freedman, MD, MSc, FRCPC, the session explored clinical and real-world evidence supporting the early use of high-efficacy DMTs in MS treatment. Discussions focused on differentiating the unique characteristics of these therapies, evaluating their role in early intervention strategies, and implementing approaches to optimize treatment sequencing for improved long-term patient outcomes. Designed for neurologists and other MS specialists, the activity provided key insights into advancing MS care through strategic and timely high-efficacy DMT utilization.²

Expanding on these discussions, Coyle, professor of neurology and the director of the MS Comprehensive Care Center at Stony Brook Medicine, spoke with NeurologyLive^® during the Forum to further elaborate on the evolution of MS treatment. She highlighted the shift from early monoclonal antibody therapies—limited by safety concerns—to the current generation of anti-CD20 agents, which offer high efficacy without black box warnings. Emphasizing the importance of personalized treatment, Coyle underscored the need to tailor therapy based on disease activity, prognosis, and patient needs. She also stressed the significance of patient education, adherence to monitoring protocols, and a holistic approach that includes wellness and comorbidity management to optimize long-term outcomes.

Click here for coverage of 2025 ACTRIMS Forum.

REFERENCES
1. Buron MD, Chalmer TA, Sellebjerg F, et al. Initial high-efficacy disease-modifying therapy in multiple sclerosis: A nationwide cohort study [published correction appears in Neurology. 2023 Mar 7;100(10):496. doi: 10.1212/WNL.0000000000201391.]. Neurology. 2020;95(8):e1041-e1051. doi:10.1212/WNL.0000000000010135
2. Giovannoni G, Patricia K. Coyle PK, Freedman MS. Industry Supported Satellite Symposium 2 - Navigating and Pioneering High Efficacy DMT Strategies: Optimizing Patient Outcomes in Multiple Sclerosis. Presented at ACTRIMS Forum 2025; February 27 to March 1; West Palm Beach, Florida. SS2.