The American Academy of Neurology (AAN) recently published their Top Five Recommendations in the Choosing Wisely Campaign in promoting high value neurological care. This was done in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports to reduce ineffective and costly care.
One of the AAN’s recommendations was to stop prescribing interferon-beta and glatiramer acetate to people who have progressive, non-relapsing forms of multiple sclerosis (MS).
The AAN made clear that the recommendations were intended to promote discussion between patients and their providers about the value of these therapies, not to completely stop the use of specific treatments.
The recommendation to stop prescribing interferon-beta and glatiramer acetate is not unanimously supported by all MS neurologists, many of whom feel that this was an oversimplification.
People with progressive forms of MS who have disease activity may still benefit from these disease modifying therapies (DMTs). Progressive patients who use these therapies and are not having relapses are also likely benefiting from their treatment and should continue using them. Younger patients with progression may also benefit from continuing therapy.
There is also evidence to suggest that people with progressive MS who stop using DMTs may have a significant relapse in disease activity. Therefore, more research to assess the safety of ending use of these therapies in progressive MS is needed before all MS neurologists can endorse this recommendation.
