Early vs. Late High-Efficacy Therapy in Multiple Sclerosis

Selecting multiple sclerosis (MS) therapies is an exercise in balancing benefits and risks. Early treatment with high-efficacy agents is hypothesized to lead to improved long-term outcomes, although more direct evidence is needed. Investigators have now used two distinct registries to evaluate patients on high-efficacy therapy with complete data from diagnosis to at least 6 years. High-efficacy therapies included rituximab, ocrelizumab, alemtuzumab, mitoxantrone, and natalizumab.

The investigators propensity-matched the early high-efficacy treatment group (i.e., those with treatment initiated within 2 years of symptom onset) to the late-treatment group (initiated 4–6 years after onset), resulting in 213 early treated patients and 253 late-tr…