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  • Treatment Philosophy
Back to Treatment Guide

Learn about the Escalation vs Early Highly Effective (EHE) approaches to treating MS

Learn about the Escalation vs Early Highly Effective (EHE) approaches to treating MS

Escalation

Escalation is the path where you begin treatment using moderately effective and safe medications. If your MS has not been adequately suppressed after a period of surveillance, your treating physician will recommend escalating treatment to a stronger, more aggressive medication. Historically, this is how MS has been treated. If you experience new lesions or relapses (breakthrough disease), it has been demonstrated that escalating to a DMT reduces disease activity. The thinking behind an escalation approach is informed by several prognostic markers such as sex, age, severity and frequency of relapses, accrual of disability, relapse type, and a number of MRI measures.

Dr. Lori Hendin Travis, MD (left) and Dr. Barry Hendin, MD

Dr. Travis is a Neurologist and MS Specialist at the MS Center of Arizona, Center for Neurology and Spine
Dr. Hendin is Chief Medical Officer of the Multiple Sclerosis Association of America

Father and daughter MS specialists, Dr. Hendin and Dr. Travis, discuss two different approaches for treating MS

Early Highly Effective (EHE)

EHE is a treatment course using aggressive medications with higher efficacy early on to help slow disease progression. Some of these medications may carry greater risk profiles for the newly diagnosed. Treating physicians give careful consideration to the potential benefits of higher efficacy therapies with their respective higher risks, and how this may align with your risk tolerance.

Dr. Lori Hendin Travis, MD (left) and Dr. Barry Hendin, MD

Dr. Travis is a Neurologist and MS Specialist at the MS Center of Arizona, Center for Neurology and Spine
Dr. Hendin is Chief Medical Officer of the Multiple Sclerosis Association of America

Father and daughter MS specialists, Dr. Hendin and Dr. Travis, discuss two different approaches for treating MS

Dr. Augusto Miravalle

Advanced Neurology of Colorado
Clinical Associate Professor of Neurology
University of Colorado

“Another important point that you need to discuss with your healthcare provider is the assumption that higher efficacy comes with higher risk, and that may or may not be true in your particular case.”

Our Risk / Benefit Matrix

As someone living with MS, it’s important to also understand the concept of risk and benefit in choosing the right disease-modifying therapy for you. In this video, Dr. Augusto Miravalle outlines the concept of Risk/Benefit in MS treatment decision-making and shares his perspective on key areas of consideration to discuss with your physician when determining the potential for new treatment options.

After viewing this video, and to help supplement your own conversations with your treating physician, please feel free to reference our Risk/Benefit Matrix and utilize it to help assess where a chosen treatment might appear in this chart in close consultation with your physician.

Dr. Augusto Miravalle

Advanced Neurology of Colorado
Clinical Associate Professor of Neurology
University of Colorado

“Another important point that you need to discuss with your healthcare provider is the assumption that higher efficacy comes with higher risk, and that may or may not be true in your particular case.”

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Last modified: Aug 15, 2022

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