The last few months have seen a quiet revolution in multiple sclerosis treatment, with the PBS listing of the 2nd and 3rd oral MS agents. The options now available for relapsing patients is quite broad, from the front line “safe” injectables, through the once daily fingolimod (Gilenya) and teriflunomide (Aubagio) and twice daily oral dimethyl fumarate (Tecfidera), to the more aggressive infusional agents. Each has its own pros and cons, and specific issues to address. However most relapsing patients should now be able to find a treatment they can tolerate, but more importantly put this still incurable disease under excellent control. If your MS patients have been reluctant to discuss treatments before now, perhaps now is the time for a further review.
Dr Nicholas Crump