In the second of her posts from MS Boston 2014, MS Trust Director of Service Development, Amy Bowen, reports on the hot topics from Day One.
It’s the end of day one at MS Boston 2014. The event is truly massive and there is an enormous amount to see and take in. Much of the focus of the day was on clinical teaching and on new researchers presenting their projects. I learned a huge amount but these are the three big three things I took away from today.
- There’s a lot of talk about early treatment of relapsing remitting MS with disease modifying drugs. Neurologists are thinking about the strength of the evidence for early treatment as opposed to a more gradual ‘watch-and-wait’ approach. They are also discussing the risks and benefits of more ‘aggressive’ treatment. How important is it to try and reduce or eliminate all signs of what the neurologists refer to as “disease activity” – not just the visible signs (such as relapses and increase in disability), but also changes which can only be seen on MRI scans? What impact does this approach have on short and longer-term outcomes? This is going to become a bigger focus for neurologists, and people with MS will need the right information to help them have better discussions with their care team about their treatment options and choices.
- In all types of MS, cognition is a big issue. Researchers and clinicians are focusing on one of the most important and often invisible problems that people with MS experience. About half of people with MS may have problems with memory and information processing. This has a massive impact on their daily life, and is a major factor in people staying in work. I heard that even though cognitive problems often lead to the decision to leave employment, the main reason that people with MS disclose their diagnosis to their employer is to do with physical problems such as walking. Cognition is a hidden issue and there is clearly a recognition that clinicians need to focus much more on asking people with MS about cognitive problems and offer support to manage them. There are now quicker and more accurate ways of assessing cognition, and different techniques for addressing cognitive problems. Clinical trials for new disease modifying treatments for all types of MS are starting to measure their effect on cognition rather than just how they affect walking or physical disability.
- Exercise helps! I heard a lot of talk and saw a lot of evidence about the value of exercise for everyone with MS at all stages of the condition. Activity helps physically, psychologically and perhaps even with cognitive problems. Exercise programmes are really important and fit well with a general approach to MS care which gives more control to the individual. This is going to be a big, big issue.
That’s all for today. More from me tomorrow.