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The management of multiple sclerosis has begun to shift away from the traditional escalation model – intensifying therapy in response to ongoing disease activity or progression – to one in which high-efficacy DMTs are used earlier in the clinical course. Read More
In September, Health Canada approved the use of a first-generation bivalent booster vaccine against the SARS CoV-2 virus for use in adults aged >18 years (www.canada.ca/en/health-canada/news/2022/09/health-canada-authorizes-first-bivalent-covid-19-booster-for-adults-18-years-and-older.html). Read More
A new review has summarized three potential biomarkers of adverse effects that may occur with disease-modifying therapies used in the treatment of MS (Kreft et al. J Neurol 2022;269:5192-5193). (Free references below.) All results are preliminary and further validation is required.
Click here to watch Dr. Virender Bhan discuss the case and the responses to the survey.
Joseph is a 28-year-old shipping manager at a local warehouse. He is married and has a three-year-old daughter. He presents in April 2021 following an episode of right sided vision loss, with minimal pain. Exam showed visual acuity 20/400, loss of colour vision and an afferent pupillary defect. The rest of his neuro exam is normal. Brain MRI revealed MS-like white-matter abnormalities with a moderate burden of disease and evidence of right optic neuritis (T2 hyperintensity and contrast enhancement). He was treated with IVMP 1000 mg daily x 3 days, with minimal improvement. There is no history of comorbid conditions and no family history of demyelinating or autoimmune disorders. He has not received a COVID-19 vaccine. Extensive discussion does not change his mind and he says he has no plans to get vaccinated. Read More