Q&A 64: Asymptomatic MS - to treat or not to treat

Case study

I am a 22-year-old male who has just been diagnosed as having radiologically-isolated syndrome (RIS). I had an MRI scan after a mild concussion whilst playing hockey. My mother, who is 54 years of age, has secondary progressive MS, is a wheelchair user and has significant problems with her cognition. My neurologist wants to start me on ofatumumab, but my insurance provider will not cover the costs of treatment for RIS. What would you recommend I do?

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Prof G’s answer

I would need to see you in person to examine you. In my experience, most patients with so-called asymptomatic MS or RIS have subtle clinical signs…..