Patricia K. Coyle, MD, of Stony Brook University Neurosciences Institute, explains how studies are trying to answer a debate about 2 approaches to treat multiple sclerosis (MS).
Transcript
What is the debate about taking an escalation approach versus a high-efficacy induction approach to treat multiple sclerosis?
Induction is a subset of high-efficacy agents that are given for a short period of time and have a long-lasting effect. So I think the first real debate is, would virtually every patient be better off if we treated them with a high-efficacy agent, as opposed to an escalating agent right from the beginning? Currently, we will typically use a high-efficacy agent in patients that we're very worried about, that have aggressive MS that have very active disease that look like they have a bad prognostic profile. Our practice guidelines recommend that, but that's a minority of MS individuals. If you have very mild disease, would you be better off if you were started on a high-efficacy agent that might carry some more risk? Or would you do very well on a very moderately efficacious but quite safe agent? We don't have the answer to that yet. To truly answer that, I think you need randomized prospective studies and there are 2 ongoing, TREAT-MS and DELIVER-MS, that are randomizing patients to a high efficacy or an escalation strategy. And they're going to see which group does better. But there is accumulating data, I think, to say that there are good things that happen when you start with a high-efficacy agent from the beginning.
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
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Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
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