Dalia Rotstein, MD, MPH, St. Michael’s Hospital and the University of Toronto, Toronto, Canada, outlines important recommendations on when to switch to a high-efficacy disease modifying therapy (DMT) for the treatment of multiple sclerosis (MS). When using an escalation approach, clinicians need to observe the patients closely, particularly in the first two years of therapy. Good evidence shows that the first two years predict how a patient will do long term. If there is breakthrough disease activity, such as new relapses or new T2 lesions, prompt escalation should be considered. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2022 in Amsterdam, The Netherlands.
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DLR has received research support from the MS Society of Canada, CMSC, University of Toronto Division of Neurology, and Roche Canada. DLR has received speaker or consulting fees from Alexion, Biogen, EMD Serono, Novartis, Roche and Sanofi Aventis.