EAN 2022 | Changing approaches to the diagnosis and treatment of multiple sclerosis

Giancarlo Comi, MD, Vita-Salute San Raffaele University, Milan, Italy, believes that clinicians must treat multiple sclerosis (MS) as soon as they know that the patient has MS. However, the question is whether there should be efforts made to anticipate treatment in the preclinical phase of MS and whether an attack is required for a patient to be defined as having MS. Prof. Comi thinks the field should reconsider patients that have not yet had an attack, since having an attack relies partially on a lesion forming in a specific site. Nevertheless, treating a patient early enough is not all. In fact, the treatment must also be adequate to combat the strength of the disease. Demographic, clinical, and instrumental markers could be employed to predict the trajectory of disease and indicate when to start aggressive therapy for the optimal benefit of the patient, keeping in mind the variation of different therapies available. This interview took place at the European Academy of Neurology (EAN) 2022 Congress in Vienna, Austria.