CONy 2022 | Changes in the MS treatment landscape over the last 2 years

Abhijit Chaudhuri, DM, MD, PhD, FACP, FRCP, FEAN, Queen’s Hospital, Romford, UK, shares an overview of the changes observed in the treatment landscape of multiple sclerosis (MS) over the last two years.
One important observation noted during the pandemic years was the relationship between the efficacy of COVID-19 vaccine responses and treatment choices. During the last couple of years, a novel anti-CD20 monoclonal antibody became available: ofatumumab, a self-administered subcutaneous injection that patients can take at home. In active relapsing MS, the early use of ocrelizumab has been observed, as well as a higher proportion of patients using oral cladribine for first-line treatment failure and as an alternative to high-efficacy therapy. For secondary progressive MS (SPMS), the approval of siponimod, an S1P modulator, was a significant addition to the treatment landscape. Until now, there have been different treatment approaches for different MS phenotypes. However, the introduction of BTK inhibitors might change that as preliminary data has shown that regardless of the phenotype, the treatment works across all groups. Autologous hematopoietic stem cell transplantation seems to be gaining ground in the MS space, but it’s not likely to be the most widely used intervention. This interview was conducted during the 2022 World Congress on Controversies in Neurology (CONy) meeting.