Canadian Neurologist Traboulsee Reflects on Today’s MS Options

The American Academy of Neurology‘s (AAN) 2017 annual meeting will bring together physicians who practice in all areas of neurology, including our own multiple sclerosis (MS) specialists. In a recent interview with Anthony Traboulsee, MD, associate professor and research chair of the MS Society of Canada at the University of British Columbia in Vancouver, we talked about his experiences and what he hopes takes place at AAN 2017.

In his 16 years of specializing in MS, Traboulsee has seen significant change in many areas, including treatment options, diagnostic tools, the importance of wellness practices, and partnering with general neurologists to ensure earlier and better care for people with MS.

When asked what attendees at AAN 2017 might hear that sparks additional interest in MS, Traboulsee didn’t hesitate to say he believes there will be interest in not only the “confirmatory information about the safety and how effective these different MS therapies are for the short term, but also the longer term information on their impact on brain volume, their impact on progression, and more importantly the impact on making people feel better and overall improvement — there will be a lot more data on all of that at the American Academy and that’s going to create a buzz,” said Traboulsee.

The other topic he thinks that will create extra buzz at AAN is the evolution of MS treatment. “It is pretty amazing — one of the biggest evolutions in medicine is what has happened in the MS world, not just with more treatments, but more effective treatment options,” he said. “When I started 17 years ago, the options were very limited, which were all roughly the same in expectations. They (disease-modifying therapies)  didn’t make people better, but they (drugs) slowed things down a bit. They were buying us time until this era where we are now, where we have higher efficacy therapies, more options, greater tolerability and a better chance of nipping this stupid disease in the bud, and preventing future damage.”

Traboulsee said he is “much more optimistic today when I diagnose someone with relapsing remitting MS. I can tell them their odds of success are not 30%,” said Traboulsee about avoiding disability with MS in the past decade. He estimates the chances are now closer to 90% to “be as good as you are today, and to live a full and productive life. That is a dramatic change in just a decade.”

“In the contemporary clinical trials, like some of the ones being presented at AAN, we’re seeing very few people progressing based on the very crude disability scale we have used. We are actually seeing people improve, only 10-15% of people over 2-5 years are showing signs of progression on these high efficacy therapies. Plus, we are seeing people improve where there is some reversal of disability. When you combine those two factors together, the chance of improvement is now greater than the chance of getting worse on our newer approach with MS. My philosophy is if we can get this as early as possible, with an accurate diagnosis and treat early, we can prevent brain injury or spinal cord injury,” Traboulsee explained.

“The nice thing about the American Academy is it is a much larger audience of general neurologists, who are the gateway for newly diagnosed patients to access MS specialists for knowledgeable MS care. Those of us working in the MS world have been very excited about the changes we see, and that excitement is leaking into the general neurology community,” he said. “Those are the people we want to tap into so that they are aware that MS is a very treatable disease, and that they get those patients to us as quickly as possible so we can start counseling and treatment discussions, so people don’t miss out on opportunities for treatment.”

This type of sharing at AAN 2017, and making others aware of the updated treatment options we now have,  benefits all of us in the MS community, especially those who are treated by general neurologists.

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