Modifying the Course of Multiple Sclerosis: The Growing Trea - Episode 13
With so many factors to consider in the treatment of multiple sclerosis, the panelists identify several “unmet needs” of patients with multiple sclerosis and discuss several options for managing them.
Moderator Peter Salgo, MD, starts the discussion by looking at other factors that can be a part of treatment, including conditions like bladder dysfunction and depression.
Stephen Krieger, MD, says that many of the treatment options the panel has been discussing have mostly involved “preventative strategies,” designed “to keep our patients from worsening.”
“And none of these medicines themselves take away symptoms that patients already have, or disabilities that they’ve already accumulated,” Krieger says. “When a patient comes to see us, they don’t necessarily care about the clinical results and the numbers of gadolinium… they want to feel better. They want their walking to be better, their bladder to be better. They don’t want to be depressed.”
As a result, Krieger says, “I do think that we need to budget the scare resource of face time that we have with our patients to some of the things that we think are important and then some of the things that they think are important and really address those things.” He adds, “They’re important drivers of quality of life and they’re what are going to keep our patients coming back to us.”
Patricia Coyle, MD, says part of that treatment should include a health maintenance wellness program.
“We know that that helps CNS reserve, brain reserve, and this is, you know, being the optimum body weight, regular aerobic exercise, not smoking, moderate alcohol, raise your vitamin D level to high-normal, make sure you’re not B12 deficient, you’re eating a good diet, you have good sleep, you have mental and social stimulation.” She adds, “These are critical things that actually treat everybody and help the central nervous system maintain itself and repair.”