Canada has the highest rate of multiple sclerosis in the world, with an estimated 90,000 to 100,000 people living with the disease.

Every day, 12 Canadians are diagnosed, most between ages 20 and 49, striking individuals during their most productive working and family-building years. “MS is the No. 1 cause of non-traumatic disability in those under the age of 40,” said Dr. Warren Berger, medical doctor, MS neurologist, adjunct professor of neurology at London Health Sciences Centre and medical director at Forest City Neurology Clinic, during a session sponsored by Roche Canada at Benefits Canada’s Drug Innovations Webinar: A spotlight on brain health.

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Beyond the physical symptoms often associated with MS, many patients struggle with invisible challenges that affect work, cognition and daily functioning, he added, noting that fatigue, slowed processing speed, short-term memory issues and bladder dysfunction can be debilitating even before mobility is impacted.

“Even minimal impairment translates to a very significant loss of productivity.”

Early and accurate diagnosis is critical, said Berger, explaining that diagnostic criteria have evolved over the past two decades to allow clinicians to identify MS much sooner. Indeed, the criteria “have progressively marched to allow us to make this diagnosis much earlier,” driven by the recognition that MS causes disability early and effective treatments are now available to change a patient’s long-term trajectory.

This shift has also transformed treatment philosophy. Historically, clinicians started patients on older, less effective therapies, he said, and escalated to new treatments only when symptoms worsened. However, he noted, new evidence shows that starting treatment early with highly effective therapies delivers better outcomes, reduces relapses and slows disability.

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Drug plans that require patients to take a step approach, failing older drugs before moving to newer treatments can create a lot of stress and delays access to the care patients need, said Berger. Since the understanding of MS continues to evolve, he added, treatment practices are increasingly shifting towards earlier and more proactive intervention.

After a period of slower drug development, new innovations are emerging, he said, noting BTK inhibitors, which can enter the brain and spinal cord directly, may offer new medications for progressive MS, which currently has minimal treatment options.

With earlier diagnosis, improved therapies and new breakthroughs on the horizon, Berger said he believes Canadians living with MS have more hope than ever for preserving quality of life, productivity and independence.