Discussions | 2 Apr 2012 Choosing Therapies May Han We currently have approximately a dozen disease modifying therapies. What is the rationale behind choice of therapy for your MS patients? How would you monitor response to therapy? Is MRI imaging sufficient? Comment4 commentsRecommendBookmarkWatch Comments Folks, The goal of immunological treatment for MS is currently evolving. It is shifting from the initial goal of slowing the progression of disability to acheiving a "disease activity free state" where possible. This means treating a patient such that they are not having relapses, have no new lesions forming on MRI and no progression of disability. This is not possible in all patients yet, but is achievable, apparently, in a some patients on the newer highly effective therapies. More recently, we are also seeing evidence in certain subsets of patients that with optimal use of certain therapies, that the patients actually improve in function over a matter of 1 to 2 years. The group most likely to achieve this response to therapy appear to be in early phase disease where fatigue, depression and cognitive complaints are the main disabling effects of MS. With several of the newer agents, there is evidence of improvement over time with these patients. We need to accelerate research in this area to determine which therapy gives each patient the best chance to not only achieve a "disease activity free state" but, possibly, recover function. My comment is that of a private individual, not engaged in research but keenly interested in remedies for the disease. My son, a doctor, developed MS in February 2008 but has just been declared free of it, following an examination by a Professor of Neurology and a further MRI scan. The remedies my son has followed have been those of Professor George Jelinek and Professor Roy Laver Swank together with medication from one drug, 'Copaxone'. Thank you for your encouraging words, however is it possible to be more specific in terms of which treatments are you talking about? For example, I was on Tysabri for 24 months and it went very well but I had to stop using it because it began giving me liver problems. I'm so happy and thankful for Gilenya. Just started Gilenya a month ago with amazing results. Started the day with an MS attack of strong body cramps and spasms and reduced vision but went home after the 6 hour study with greatly reduced cramps and better vision than I'd had in about 9 years. Now only have mild spasms and some unusual numbness. I'll take it!! My main side effect is terrible light sensitivity and migraine headache. I'm taking imitrix with some relief. Also started taking Gilenya at night instead of early morning, and that seems to be helping. Had posted elsewhere my interest in migraine glasses (tinted lenses said to reduce light sensitivity.) Is there any advice on these lenses?