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Dr Patricia Coyle Underscores the Importance of Diagnosing and Treating MS Early


Emerging data is showing that treatment within 6 months of presentation of multiple sclerosis (MS) is ideal, explained Patricia K. Coyle, MD, of Stony Brook University Neurosciences Institute.

The time from symptom onset to diagnosis can be a year or 2 years, which is a concern when emerging data is showing that treatment within 6 months of presentation is ideal , explained Patricia K. Coyle, MD, director of the MS Comprehensive Care Center and professor of neurology at Stony Brook University Neurosciences Institute.


There is a push to diagnose multiple sclerosis earlier. Currently, what is the typical time from symptom onset to diagnosis?

Surprisingly, it can be a year or 2. It can be quite a lag phase. I think that's why people have to recognize the suggestive features for MS, understand there should be a robust laboratory workup, and apply the 2017 McDonald diagnostic criteria. It's been shown that there's a gap in knowledge about those formal criteria, both among MS experts and neurology residents in the United States. We need to really get our act together and be very familiar and use those formal diagnostic criteria.

Early treatment of multiple sclerosis is better, but how much better?

The data is clearly, steadily accumulating that a group of MS patients who are treated earlier compared to a group that are somewhat delayed, the early treatment is doing better. And that's a consistent finding of every single study.

And actually, the first couple of months may be critical. Very akin to rheumatoid arthritis, where they have great data that after the presentation, if you don't institute treatment, within 3 to 6 months, that person will have permanent bone and joint injury several years later. I think we're getting accumulating evidence from MS that you really do want to treat within, ideally, 6 months of presentation.

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