João José Cerqueira, MD, PhD, University of Minho, Braga, Portugal, discusses the use of high-efficacy (HE) disease-modifying therapies at the initial stages of multiple sclerosis (MS). Although this has been a crucial question in the MS space, there is sufficient evidence showing that starting HE treatments in the early stages of the disease leads to better results than starting with a moderate-efficacy drug. Some exceptions would be patients with a very mild disease without bad prognostic factors and very few lesions. Otherwise, most patients would benefit from HE treatment early on. One of the concerns with starting HE treatments is their safety profile. Currently, there are various HE drugs available that have shown a favorable long-term safety profile. Therefore, clinicians should consider using HE medications at the initial stages of the disease. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2022 in Amsterdam, The Netherlands.
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