Delay From Treatment Start to Full Effect of Immunotherapies for Multiple Sclerosis

Izanne Roos; Emmanuelle Leray; Federico Frascoli; Romain Casey; J. William L. Brown; Dana Horakova; Eva K. Havrdova; Maria Trojano; Francesco Patti; Guillermo Izquierdo; Sara Eichau; Marco Onofrj; Alessandra Lugaresi; Alexandre Prat; Marc Girard; Pierre Grammond; Patrizia Sola; Diana Ferraro; Serkan Ozakbas; Roberto Bergamaschi; Maria José Sá; Elisabetta Cartechini; Cavit Boz; Franco Granella; Raymond Hupperts; Murat Terzi; Jeannette Lechner-Scott; Daniele Spitaleri; Vincent Van Pesch; Aysun Soysal; Javier Olascoaga; Julie Prevost; Eduardo Aguera-Morales; Mark Slee; Tunde Csepany; Recai Turkoglu; Youssef Sidhom; Riadh Gouider; Bart Van Wijmeersch; Pamela McCombe; Richard Macdonell; Alasdair Coles; Charles B. Malpas; Helmut Butzkueven; Sandra Vukusic; Tomas Kalincik


Brain. 2020;143(9):2742-2756. 

In This Article


Accurate expectations regarding the time required for full clinically manifest treatment effect has important implications for therapeutic decisions, particularly during the initial months after patients have commenced new multiple sclerosis immunotherapies. In this observational study, the lag to a measurable maximum effect of therapies on relapses and progression of disability was 3–7 and 7–16 months, respectively. Objectively defined periods of expected therapeutic lag for the presently used therapies allows insights into the evaluation of treatment response in randomized clinical trials and may guide clinical decision-making in patients who experience early on-treatment disease activity. Further exploration of the influence different patient or disease characteristics have on the duration of therapeutic lag will allow personalization of care in patients who commence different therapies in various clinical scenarios.