Short-Term Wins vs Long-Term Gains: Rethinking MS Treatment Value

EP: 1.Understanding PIRA and Its Clinical Significance in MS

EP: 2.Measuring What Matters: Evidence and End Points That Define Disability in MS

EP: 3.Closing the Gaps: Therapeutic Performance and the Promise of Innovation

EP: 4.Digging Deeper: Mechanisms of Progression and the Case for a Dual Therapeutic Approach

EP: 5.Aligning Evidence With Access: Disability Outcomes, Data, and Payer Decision-Making

EP: 6.Bridging the Gaps: BTK Inhibitors and the Future of MS Care

EP: 7.Redefining Value: What Payers Want From Comprehensive MS Treatments

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EP: 8.Short-Term Wins vs Long-Term Gains: Rethinking MS Treatment Value

EP: 9.Evaluating the Future of MS Therapies: Balancing Early Data With Delayed Outcomes

Video content above is prompted by the following:

The Expanded Disability Status Scale (EDSS) remains the gold standard for measuring multiple sclerosis (MS) disability progression, but its implementation challenges limit real-world utility. This 0-10 scale primarily measures physical mobility and requires trained administrators, making routine clinical use impractical. Alternative measures like the Patient Determined Disease Steps (PDSS), 25-foot timed walk, and 9-hole peg test offer more feasible options for clinical practice, providing validated assessments of disability progression that correlate well with EDSS scores while requiring minimal additional time and resources.

Traditional MS treatment evaluation has focused heavily on relapse reduction and MRI lesion activity, but the field is evolving toward measuring disability progression independent of relapses. The challenge lies in identifying the transition point when patients move from relapsing to progressive disease phases, as this shift often occurs insidiously over years. Clinicians must simultaneously monitor both relapse activity and subtle disability progression, as patients may appear clinically stable while accumulating irreversible neurological damage.

The integration of functional assessments into routine MS care requires standardized, validated measures that can be efficiently implemented across diverse clinical settings. While various disability scales exist, their practical utility is limited by complexity, time constraints, and lack of standardization. Future developments in wearable technology and digital health monitoring may offer solutions for continuous disability tracking outside clinical visits, though standardization and data ownership challenges remain significant barriers to widespread adoption.