Precision medicine in the multiple sclerosis clinic: Selecting the right patient for the right treatment

Mult Scler. 2020 Apr;26(5):540-547. doi: 10.1177/1352458519887324. Epub 2020 Jan 22.

Abstract

Multiple sclerosis (MS) is a chronic, inflammatory disease of the central nervous system (CNS), affecting patients of all ages, causing neurologic disability if inadequately treated. Some patients have a relatively benign disease course without significant disability after decades, while a more aggressive course ensues in others and disability progression occurs after only several years. Certain risk factors confer a higher chance of a patient having aggressive MS. Currently over 15 disease-modifying treatments (DMTs) are approved for MS with different efficacy and safety profiles. Deciding which DMT to use in a specific patient requires a careful analysis of a patient's disease course for high-risk factors for early progression, consideration of the efficacy and safety profile for potential therapy, as well as understanding of a patient's lifestyle and expectations. The integration of these factors is the art of precision medicine, a necessary practice in the treatment of patients with MS.

Keywords: Multiple sclerosis; neurology; patient-centered care; precision medicine.

Publication types

  • Review

MeSH terms

  • Humans
  • Immunologic Factors / administration & dosage*
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / drug therapy*
  • Patient-Centered Care* / methods
  • Patient-Centered Care* / standards
  • Precision Medicine* / methods
  • Precision Medicine* / standards

Substances

  • Immunologic Factors