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Neurol Sci. 2008 Sep;29 Suppl 2:S250-2. doi: 10.1007/s10072-008-0953-y.

Induction vs. escalation of therapy for relapsing multiple sclerosis: the evidence.

Author information

1
Multiple Sclerosis Research Unit, The Ottawa Hospital General Campus, University of Ottawa, Ottawa, Canada. mfreedman@ottawahospital.on.ca

Abstract

Not all patients presenting with their first attack of multiple sclerosis (MS) or early thereafter are necessarily in the same phase of disease; some truly present early with minimal disease, whereas others present late, having accumulated already considerable damage to the central nervous system (CNS). This beckons a different approach to therapy depending on "where" a patient may be in the course of disease. If early, then any of the current first line immunomodulating agents may be appropriate, whereas later disease calls for a more aggressive approach entailing either induction with a more powerful but riskier treatment or an escalation approach, moving through first line agents and stepping up to more aggressive treatments. This paper discusses the rationale for either regimen.

PMID:
18690508
DOI:
10.1007/s10072-008-0953-y
[Indexed for MEDLINE]

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