I had many requests for my #ECTRIMS2019 ‘Hot Topic’ slides on ‘what remains to be achieved from DMTs’. You can download the slides from my SlideShare site.
My message is blunt and to the point. Let’s not let ourselves be lulled into a false sense of security with our current crop of DMTs. They are simply not good enough. If we want to ‘maximise the lifelong brain health’ of MSers we need to do better; much, much better than what we are currently doing.
In my presentation I made the case for new treatment approaches in particular combination therapies and a true induction strategy, i.e. an induction therapy followed by a maintenance or consolidation therapy. I also made the case for making our current DMTs safer and promoted the holistic management of MS using the principle of ‘marginal gains’.
I didn’t pull my punches and questioned if we have equipoise when it comes to randomising MSers to an escalation or high-efficacy (flipping the pyramid) treatment approach.