Managing CIS or Relapsing MS Without Current Disease-Modifying Therapy

Some patients with clinically isolated syndrome (CIS) or a relapsing form of multiple sclerosis are not currently receiving disease-modifying therapy, have had no relapses in the preceding two years, and show no active new lesion activity on recent MRI. This specific, stable clinical profile calls for a distinct management approach.

Clinical Scenario

Clinically isolated syndrome or relapsing multiple sclerosis — currently not on disease-modifying therapy, no relapses recorded in the past 2 years, and no active new MRI lesion activity on recent imaging.

Treatment Approach (partial)

Rather than immediately initiating disease-modifying therapy, the structured approach for this stable profile centres on a sustained monitoring strategy involving serial MRI imaging. The full protocol specifies the cadence, duration, and decision points …

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1212/WNL.0000000000005347

Clinicians may recommend serial imaging at least annually for the first 5 years and close follow-up rather than initiating DMT in people with CIS or relapsing forms of MS who are not on DMT, have not had relapses in the preceding 2 years, and do not have active new MRI lesion activity on recent imaging (Level C).

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