Multidisciplinary, Holistic Approach Appears Effective in MS Treatment

Almost twice as many young women than men account for the 60% of Canadian adults with multiple sclerosis (MS) diagnosed between ages 20 and 49 years. Researchers developed an expert review of the most common comorbidities, as well as effective management styles available.

Published in Neurodegenerative Disease Management, researchers highlight that MS is one of the most common chronic neurological diseases, and that it is linked with a highly variable degree of disability in those affected. Young women of childbearing age serve as a distinct at-risk population. They have a 3 times greater risk of being affected by MS compared with young men.

When initiating treatment, the researchers stress that clinicians must consider the nature of the disease and provide a long-term treatment plan that is individualized by patient and disease-related characteristics. The 5 most prominent comorbidities linked with MS are depression, anxiety, hypertension, hyperlipidemia, and chronic lung disease. And yet, little is known on what point in the disease course these factors pose the most risk for patients.

Expanding knowledge on the incidence and prevalence of these comorbidities for patients with MS could prove crucial, as they not only impact factors such as disability progression, quality of life (QOL), and mortality risk, but can also cause diagnostic delay, exacerbate risk of hospitalization, and increase the risk of relapse. “In addition, comorbidities play a role in the choice of disease-modifying therapy, tolerance to therapy, and long-term adherence,” said the study authors. The economic burden of these comorbidities was also cited, as MS’ prevalence in younger populations can impact productivity and long-term healthcare cost.

The researchers note that because MS-related symptoms are complex and interrelated, optimal management of the disease needs a holistic, multidisciplinary approach that includes patient education and empowerment. “In addition to delaying disease progression and managing symptoms, assessing and promoting QOL and general well-being should be a principal goal of treatment. For many young women with MS, this remains an unmet need,” said the study authors.

The authors noted the importance of these 5 characteristics (the 5Cs) in properly designing a treatment plan. Each plan must be comprehensive, coordinated, community based, close to home, and care for patients with MS. The importance of a holistic, multidisciplinary approach was again referenced, characterized by clinical care, patient education, and the opportunity for research into improved care for patients with MS.

In examining the future of MS care, the researchers said that the incorporation of a precision medicine approach that identifies biomarkers for the disease would add value to the holistic care of patients. “The multidisciplinary, holistic approach represents a promising evolution in the model of care for young women with MS. It can be extrapolated and used in other chronic diseases, which require complex, lifelong collaboration of healthcare professionals to provide patients with full support and help them to maintain their QOL,” noted the study authors.

Reference

Vorobeychik G, Black D, Cooper P, Cox A. Multiple sclerosis and related challenges to young women’s health: Canadian expert review [published May 6, 2020]. Neurodegener Dis Manag. doi:10.2217/nmt-2020-0010