In MS, timing is everything


	Prompt treatment in MS to reduce disease activity^1,2

The optimal window of impact may be during the early phase of relapsing MS, when inflammatory disease activity is at its peak^3,4

Some studies have shown that the potential benefits of early treatment include delay in time to a second relapse,*^† delay of long-term disability,^‡§ and a reduction in the risk of progression to secondary progressive MS^3-5||

"I like to get my patients that are newly diagnosed on treatment right away... unfortunately, we see patients that come in in their late 50s and 60s. And now, they want that aggressive treatment. But the opportunity to [impact] the disease is early on."

Barry Singer, MD
Director, MS Center for Innovations in Care,
Missouri Baptist Medical Center

Learn about the limited window
of opportunity in treatment

*	Randomized, double-blind, placebo-controlled study in patients with a first demyelinating event and at least 2 clinically silent brain MRI lesions that assessed the effect of IFN-beta-1b every other day (n=292), or placebo (n=176), until clinically definite MS was diagnosed or until they had been followed for 24 months. IFN-beta-1b significantly slowed the development of recurrent active disease from its onset to the second new event compared with placebo (HR=0.50 [95% CI 0.36-0.70]; P<0.0001).³
^†	Not all approved DMTs have demonstrated this benefit.
^‡	Observational study in 3060 MS patients that analyzed the effect of therapy on progression to Expanded Disability Status Scale (EDSS) 3.0 and 6.0 from onset in treated patients (TP) vs untreated patients (UTP). The risk of progression to EDSS 3.0 in the 1735 TP was 90% lower than in the 781 UTP (HR=0.10 [95% CI 0.07-0.14]; P<0.001). The risk of progression to EDSS 6.0 in the 1904 TP was 62% lower than in the 539 UTP (HR=0.38 [95% CI 0.28-0.52]; P<0.001).⁴
^§	No DMTs, including those from Biogen, have been FDA-approved to demonstrate this benefit.
^\|\|	Observational study of 1178 patients with relapsing MS at onset and at least 10 years of disease duration, treated or untreated with DMTs, that assessed the efficacy of DMTs on long-term evolution of MS. TP (n=148) had a significantly lower risk of reaching secondary progressive MS than UTP (n=147) (RR=0.231 [95% CI 0.151-0.349]; P<0.000001).⁵

References: 1. Giovannoni G, Butzkueven H, Dhib-Jalbut S, et al. Mult Scler Relat Disord. 2016;9(suppl 1):S5-S48. 2. Ziemssen T, Derfuss T, de Stefano N, et al. J Neurol. 2016;263(6):1053-1065. 3. Bates D. Neurology. 2011;76(1, suppl 1):S14-S25. 4. Cocco E, Sardu C, Spinicci G, et al. Mult Scler. 2015;21(4):433-441. 5. Bergamaschi R, Quaglini S, Tavazzi E, et al. Mult Scler. 2016;22(13):1732-1740.

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