Precision medicine in the multiple sclerosis clinic: Selecting the right patient for the right treatment.
Gauruv BoseMark S FreedmanPublished in: Multiple sclerosis (Houndmills, Basingstoke, England) (2020)
Multiple sclerosis (MS) is a chronic, inflammatory disease of the central nervous system (CNS), affecting patients of all ages, causing neurologic disability if inadequately treated. Some patients have a relatively benign disease course without significant disability after decades, while a more aggressive course ensues in others and disability progression occurs after only several years. Certain risk factors confer a higher chance of a patient having aggressive MS. Currently over 15 disease-modifying treatments (DMTs) are approved for MS with different efficacy and safety profiles. Deciding which DMT to use in a specific patient requires a careful analysis of a patient's disease course for high-risk factors for early progression, consideration of the efficacy and safety profile for potential therapy, as well as understanding of a patient's lifestyle and expectations. The integration of these factors is the art of precision medicine, a necessary practice in the treatment of patients with MS.
Keyphrases
- multiple sclerosis
- case report
- end stage renal disease
- mass spectrometry
- risk factors
- newly diagnosed
- ms ms
- white matter
- healthcare
- prognostic factors
- stem cells
- peritoneal dialysis
- metabolic syndrome
- physical activity
- oxidative stress
- cardiovascular disease
- blood brain barrier
- weight loss
- mesenchymal stem cells
- cerebrospinal fluid
- drug induced
- combination therapy
- bone marrow
- patient reported