What strategy is recommended for MRI usage before starting disease-modifying therapy (DMT)?

The recommended strategy of using MRI to demonstrate new activity before starting disease-modifying therapy (DMT) aligns with the clinical approach to managing multiple sclerosis (MS). MRI is a critical tool in the evaluation of disease activity and progression in MS. By capturing images that reveal the presence of new lesions or changes in existing ones, healthcare providers can assess the current state of the disease.

Demonstrating new activity through MRI provides valuable information to guide treatment decisions. If new lesions are detected, this may indicate that the disease is not adequately controlled and could justify the initiation or change of therapy. It allows clinicians to tailor DMT choices based on the most up-to-date information about the patient’s disease status.

In contrast to this approach, using MRI every six months, only once at diagnosis, or only in response to worsening symptoms does not provide the same level of insight into ongoing disease activity. Regular MRI scans every six months could lead to unnecessary imaging and costs without providing actionable data if no new activity is evident. Limiting MRI use to once at diagnosis neglects the importance of monitoring disease progression over time. Similarly, waiting for symptoms to worsen before performing an MRI could result in delays in addressing disease activity, which could have long-term implications for the patient's health and