Neurológia pre prax 6/2023

Early highefficacy mulitple sclerosis treatment: therapeutic success despite safety barriers

The presented case report illustrates the use of high-efficacy therapy in the early stages of multiple sclerosis as an effective strategy. Numerous studies from real clinical practice confirm the superior effectiveness of this approach. However, in addition to the effectiveness of the therapy, it is crucial to monitor side effects and to intervene early. With the expanding range of disease-modifying therapies (DMT), the appropriate sequencing of individual drugs is another pressing issue. For patients treated with some DMT (S1P modulators, natalizumab) the risk of rebound phenomenon should also be considered when looking for subsequent therapy. One option that appears to be appropriate from the available data is the initiation of ocrelizumab. Non-pharmacological approaches must not be forgotten in the management of therapy, too.

Keywords: multiple sclerosis, high efficacy therapy, disease‑modifying therapy, ocrelizumab, natalizumab, adverse effects, safety, reimbursement criteria