Scott D. Newsome, DO, on New MS Disease-Modifying Therapies
The landscape of multiple sclerosis (MS) disease-modifying therapies (DMTs) is constantly changing. As new therapies emerge, it becomes more difficult to make treatment decisions for an individual with MS.
A clinical session at the 2019 American Academy of Neurology’s Annual Meeting1 aimed to overview the efficacy and safety profiles of current and late-stage emerging MS DMTs. Speaker Scott D. Newsome, DO, answered some of our burning questions.
Scott D. Newsome, DO, is the director of Neurosciences Consultation and Infusion Center at Green Spring Station in Lutherville-Timonium, Maryland, and is an associate professor of neurology at Johns Hopkins Medicine in Baltimore, Maryland.
NEUROLOGY CONSULTANT: What clinical advances have been made in MS DMTs over the past year?
Scott Newsome: It is an exciting time for people with MS, as the number of treatment options continues to increase for different types of MS. There are now almost 20 FDA-approved therapies that, in clinical trials, have helped minimize the immune system’s attack in MS. Two new oral therapies have been approved this past year that have approval for use not only in patients with relapsing remitting MS, but also in patients with active secondary progressive MS and the very early stages of MS called clinically isolated syndrome. Over the last several years, the number of high-efficacy therapies has increased, which is offering people with MS treatment options that have a very robust impact on preventing new inflammatory attacks and lesions on magnetic resonance imaging (MRI) beyond some of our other medications.
NEURO CON: How can general neurologists better prescribe and monitor these treatments in their patients with MS?
SN: It is important for clinicians to be very familiar with the prescribing information for each medication and be proactive in partnering with an MS specialist to help with the care of complicated patients and with some of the complicated medications that are prescribed. Also, there are many continuing medical education programs online and at annual conferences that could be informative.
NEURO CON: What new DMTs are on the horizon?
SN: There are a couple oral and subcutaneously administered DMTs that have potential for future approval. Potentially more exciting is future putative remyelinating and neuroprotective therapies. There are several of these types of therapies in clinical trials now.
NEURO CON: What challenges do you face when prescribing a new DMT to a patient with MS? How do you overcome these challenges?
SN: The biggest challenge I face is getting newly diagnosed patients to understand that MS is a treatable disease and that what we do today will impact what happens in the future. There are some patients who do not want to do anything outside of non-medication interventions, and we try to impress upon these people with MS that we need to take a multifaceted and multidisciplinary treatment approach that includes pharmacological and nonpharmacological interventions. Spending extra time during the follow-up visits with these patients and impressing upon them that this is a shared-decision-making model of care can help.
NEURO CON: Do you have any other advice for neurologists who might be facing challenging patients with MS?
SN: I recommend partnering with an MS specialist, and it is always a good rule of thumb to get a second opinion on these challenging patients. It takes a team approach to help people with MS. Also, a little extra time during face-to-face visits goes a long way!
Reference:
- Newsome S. Multiple sclerosis overview II: clinical advances. Talk presented at: 2019 American Academy of Neurology’s Annual Meeting; May 4-10, 2019: Philadelphia, PA. http://tools.aan.com/annualmeeting/search/index.cfm?fuseaction=home.detail&id=7042&keyword=&topic=&type=all.
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