A useful presentation. However, I found it disconcerting that Dr Baker hasn’t acknowledged that his treatment approach isn’t universal. As I understand it most neurologists use the escalation approach, as described. However there is the induction approach - hit it hard with one of the most effective treatments available. Equally, some neurologists view a relapse as evidence of the loss of efficacy of the current DMT and will move the patient on to a stronger med. Dr Baker usefully describes reasons for high disease burden and lower levels of neurological symptoms and I think that the position of ‘Brain health: time matters in MS’ is vitally important, both in terms of treatment and self care.
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