‘We have to now spend our energy trying to optimize what is already in our hands’. Giancarlo Comi, MD, Vita-Salute San Raffaele University, Milan, Italy, comments on the importance of optimizing the use of currently available treatments for patients with multiple sclerosis (MS). Years of dedication to the development of novel treatments for relapsing-remitting MS has led to around 20 agents available today. Prof. Comi highlights the importance of treatment optimization as a critical next step. Part of this will come from an improved understanding of prognostic factors to better predict individual patient trajectories. Determining the course of a patient’s disease is important for optimal management so the appropriate level of treatment intensity can be given. This interview took place during the European Academy of Neurology 2021 congress.