Measuring treatment outcomes as
Solution
The following is an extract from a journal I came across the other day:
Optimizing treatment outcomes with disease-modifying therapies involves several factors:
Initiating the appropriate treatment at the appropriate time. Most MS specialists advocate for
early intervention, although differences of opinion exist within the MS community:
Hawkins, 2012 vs. Amato, 2012
Pittock et al., 2006 vs. Frohman et al., 2006
The following image of the natural history of MS indicates the significant amount of MRI
activity that occurs in the pre-clinical phase and early relapsing-remitting MS, the gradual
decrease in inflammatory attacks (relapses) over time, and the increasing MRI burden of disease
that occurs along with a decrease in brain volume. This schematic supports the role of DMTs
early in the disease course.
CMS_ms.natural.history (.png)
Explaining to patients and family members about the purpose of disease-modifying therapies
in MS management (Rio et al., 2005)
Setting realistic expectations for the treatment; unrealistic expectations are a common reason
why patients discontinue their medication (Mohr et al., 1996).
Instructing patients on proper use of a medication, particularly injection techniques and
rotation regimens to minimize skin reactions with injectable medications (Saunders et al., 2010;
Webb, 2008).
Monitoring for side effects and providing management strategies; inadequate management of
side effects is another key reason why people discontinue their medication (Webb, 2008).
Identifying a sub-optimal response (Cohen et al., 2004; Waubant, 2012)
Treating sub-optimal responders
Increasing from a lower dose to a higher dose IFN beta medication (Durelli et al., 2002;
Panitch et al., 2002; Schwid & Panitch, 2007) in the absence of neutralizing antibodies.
Switching from an IFN beta medication to glatiramer acetate or vice versa (Freedman et al.,
2009; Caon, 2009)
Switching from an injectable to fingolimod (Marriott & O.
Measuring treatment outcomes asSolutionThe following is an ext.pdf
1. Measuring treatment outcomes as
Solution
The following is an extract from a journal I came across the other day:
Optimizing treatment outcomes with disease-modifying therapies involves several factors:
Initiating the appropriate treatment at the appropriate time. Most MS specialists advocate for
early intervention, although differences of opinion exist within the MS community:
Hawkins, 2012 vs. Amato, 2012
Pittock et al., 2006 vs. Frohman et al., 2006
The following image of the natural history of MS indicates the significant amount of MRI
activity that occurs in the pre-clinical phase and early relapsing-remitting MS, the gradual
decrease in inflammatory attacks (relapses) over time, and the increasing MRI burden of disease
that occurs along with a decrease in brain volume. This schematic supports the role of DMTs
early in the disease course.
CMS_ms.natural.history (.png)
Explaining to patients and family members about the purpose of disease-modifying therapies
in MS management (Rio et al., 2005)
Setting realistic expectations for the treatment; unrealistic expectations are a common reason
why patients discontinue their medication (Mohr et al., 1996).
Instructing patients on proper use of a medication, particularly injection techniques and
rotation regimens to minimize skin reactions with injectable medications (Saunders et al., 2010;
Webb, 2008).
Monitoring for side effects and providing management strategies; inadequate management of
side effects is another key reason why people discontinue their medication (Webb, 2008).
Identifying a sub-optimal response (Cohen et al., 2004; Waubant, 2012)
2. Treating sub-optimal responders
Increasing from a lower dose to a higher dose IFN beta medication (Durelli et al., 2002;
Panitch et al., 2002; Schwid & Panitch, 2007) in the absence of neutralizing antibodies.
Switching from an IFN beta medication to glatiramer acetate or vice versa (Freedman et al.,
2009; Caon, 2009)
Switching from an injectable to fingolimod (Marriott & O
