Case
My brother is 35 and has just been diagnosed with multiple sclerosis.
He experienced numbness and pins and needles sensations over his abdomen and leg over two weeks. His general practitioner promptly referred him to a neurologist, where he underwent a spinal MRI. The results revealed abnormalities necessitating an admission to the hospital. Subsequent tests, including a lumbar puncture and brain MRI, confirmed the presence of lesions indicative of MS. In the interim, he has received intravenous steroids. In a follow-up consultation, participation in a clinical trial was proposed. The trial is: "Efficacy and Safety of Remibrutinib Compared to Teriflunomide in Participants With Relapsing Multiple Sclerosis" (nct05147220).
Questions
We are seeking your expert opinion on the following questions we have:
Q1: Is the clinical trial recommended the optimal course of action for my brother?
Q2: We note that Teriflunomide, the "control drug", is rated as having "moderate effectiveness" on the MS Trust Drug Comparison tool. Given the possibility of limited access to higher efficacy drugs in the country he lives in compared to high-income, could this impact his outcome?
Q3: Would you recommend a second opinion?
Q4: Considering the potential benefits of higher efficacy drugs, would it be feasible to access such treatments in another country?
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Answers
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