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Preserving the Brain: How Advances in Pathogenesis Are Fueling New Approaches to Treatment and Highlighting the Need for Biomarkers - A Q&A With Thomas P. Leist, MD, PhD

Preserving the Brain: How Advances in Pathogenesis Are Fueling New Approaches to Treatment and Highlighting the Need for Biomarkers - A Q&A With Thomas P. Leist, MD, PhD

AJMC®: Given the new directions we are seeing in pathogenesis and treatment, how do you see the MS spectrum taking shape over the next several years?

Leist: We are in an era in which we have a number of treatments in our armamentarium. With that, we really need to work hard to prevent disability progression in a given patient. What this also requires is regular monitoring and standardized methods of assessing patients. This will allow more timely recognition when someone is not doing well. This will include integration of wearable technologies.

We have many treatments that have proven efficacy. If one thing is clear, it is that early and effective treatment very often affords patients greater treatment success with the possibility of disease remission in some. When patients have disease activity, they need to be able to switch to other medications that afford the possibility of a better response. Recycling previously experienced modes of action is not in the interest of the patient.

Looking forward, we would like to prevent progression of disease. This will require agents that go above and beyond immunomodulation, and it will require a new set of outcome measures. Without measures, it will be very different to establish an efficacy claim. We need agents that can claim neuroprotection and cognitive preservation for the overall preservation of the brain.
 

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