A reflection on unique patient stories and shifting clinical practice

Turning the page: Advances in multiple sclerosis clinical practice

By: Paulo Fontoura, MD, PhD, Global Head Clinical Development, Neuroscience

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For many years, I worked as a neurologist and academic researcher in Multiple Sclerosis (MS). When I started in the field in the early 90s, the majority of patients I encountered had advanced disease and only received occasional steroid treatment or other immune-suppressing medicines. There was little we could do to alter the disease course at that time. Gradually, that changed with greater availability of disease-modifying therapies.

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A photo one of my patients took of me during my days as a clinician

Over time, more emphasis was placed on early diagnosis and treatment, including the use of magnetic resonance imaging (MRI) to diagnose and monitor the disease. A new generation of patients began to appear – those who were treated from very early in their disease course and empowered to help manage their condition.

We’ve learned that disease activity can occur even when people do not show signs or symptoms of MS, and despite available treatments. This ongoing disease activity damages nerve cells and myelin (nerve cell insulation and support), which can lead to disability. We now know we need to go beyond symptom control to try to completely suppress disease activity using highly efficacious medicines.

We need to go beyond symptom control to try to completely suppress disease activity using highly efficacious medicines.

Despite the advances in clinical practice, each person with MS has a lot to teach us. I was privileged to work closely with many patients, and am thankful for the experiences and insights they shared.

In fact, two of our colleagues affected by MS bravely shared their stories recently. Their journeys illustrate the variability – and individual impact – of the disease. They also represent why our neuroscience team and I are committed to improving the understanding of the biology of MS; we hope to develop new ways to control disease activity and, perhaps, ultimately find a cure.

The next chapter in the story of MS has yet to be written.

Tags: Science, Multiple sclerosis