This New Tool Can Help You Choose Which DMT to Use

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by Ed Tobias |

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Sometimes it seems as if people with MS are asked to flip a coin to make what’s arguably the most important decision about their treatment: which disease-modifying therapy (DMT) to use.

More than 20 DMTs are approved in the U.S., similar to what’s available in the rest of the world. DMTs are administered via pills, injections, and infusions, and their efficacy, side effects, and costs vary significantly. One size does not fit all.

Yet, too many neurologists present MS patients with only the names of two or three DMTs to choose from. Patients are left to navigate the complex DMT waters on their own. While this is understandably difficult for people who are new to MS, it’s also not an easy decision for old-timers.

Wouldn’t it be nice if there was a way to logically choose the best DMT by taking into consideration a person’s level of disability, lifestyle, and risk tolerance? Well, this method currently is in the works.

Enter the DMT tool

A group of MS specialists at Barts Health in London is developing a “DMT tool,” which is an online application designed to remove much of the uncertainty when choosing a DMT. It does this by determining a patient’s unique health and lifestyle factors and matching their needs with the appropriate medications.

For example, do you care whether a treatment comes as a pill, injection, or infusion? Will a relatively minor side effect, such as flushing or hair loss, bother you? What about long-term side effects? Are you able to regularly visit a doctor’s office or other location to be treated? Are you more interested in preventing relapses than in slowing long-term disability? Do you plan to become pregnant?

“The goal of this DMT tool is empowering pwMS to pick a treatment ‘rationally’ after being offered two or three drugs by their MS team,” Barts Health neurologist Ide Smits wrote on the MS-Blog. “In our opinion, a rational treatment choice translates into a drug with a high efficacy when it comes to treating your MS but is equally compatible with your lifestyle, personal and professional ambitions.”

Test-driving the DMT tool

I’ve had a look at the DMT tool, which is currently being beta-tested, and I’m impressed.

To use it, first select the DMTs your neurologist has suggested. (The tool lists nine available in the U.K.)

Then, use a pull-down menu to answer eight questions about your healthcare and lifestyle needs. Answers range from unimportant to very important.

The tool will then suggest which health or lifestyle factors might be associated with each question, such as active or quiet MS, frequent travel, or busy schedule, for example.

When that’s finished, you can click a button, and you’re presented with two graphs. A bar graph shows the level of suitability of each DMT you’re considering, while a line graph shows how each DMT ranks for each of the eight considerations you used.

(Graphics courtesy of Barts Health)

The proof is in the DMT selection

I entered the four DMTs I’ve been treated with — Avonex, Tysabri, Aubagio, and Lemtrada — and answered the eight questions. As shown in the graphs above, the tool ranked the DMTs from most to least suitable for me: Lemtrada, Tysabri, Aubagio, and Avonex. That’s exactly how I would have ranked them based on my actual experience with each.

Wow!

The members of the team that designed this MS tool are anxious to have people try it out and provide feedback on its design, content, and overall usefulness. A link to do so can be found at the bottom of the testing site.

I encourage everyone to take a look and let the folks at Barts know what you think.

You’re invited to visit my personal blog at www.themswire.com.

***

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.

Comments

Leanne Broughton avatar

Leanne Broughton

Wow. What a great idea. Many times I have never heard of the newest drug and there is little feedback from other MSers.

Reply
Ed Tobias avatar

Ed Tobias

Leanne,

Keep in mind that this tool is just being tested right now and even when it's ready for "prime time" you'll want to use it to help you discuss medications with your neurologist. But, it absolutely should help in making this important choice.

Ed

Reply
Barb Kiskiras avatar

Barb Kiskiras

I have been asking the question for 4 + years, as more drugs are available and which would be best for me and my MS symptoms. Great start!

Reply
Philip Siddons avatar

Philip Siddons

I have didn’t see Ocrevus.

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Ed Tobias avatar

Ed Tobias

Hi Philip,

If you click the link to look at the DMT tool you'll see that it's the first one listed.

Ed

Reply
Heather avatar

Heather

Good tool, especially now that I have been living with MS since 2002. Having tried the injections which was all that were available to me at the time of my diagnosis. I'm grateful that they now have DMT's in pill form. Much easier to administer, stay compliant and less side effects. The only thing I would like to see differently is if the DMT test would be able to tell me which of ALL the approved DMT's would be best for me, not just the ones offered to me. This would be especially important when I was first diagnosed.

Reply
Ed Tobias avatar

Ed Tobias

Hi Heather,

The tool allows you to click on any of the nine DMTs that are listed. I've suggested to the creators that they include as many of the 20+ DMTs as possible. You can also suggest that directly to them by using the link in the column to go to the tool, testing it and then writing a comment.

Ed

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