Dr Cottrell focused on relapses. Prof G was more convincingTo some extent they were arguing at cross purposes: Dr Cottrell said we shouldn't treat RIS without evidence and prescription guidelines, and I very much doubt whether Prof G plans to go rogue and prescribe DMTs in cases of RIS Prof G's rejoinder to the point about costs and budgets wasn't entirely convincing. Yes, eventually the DMTs should come out of patent and become more affordable. But when? At the moment they're still exorbitantAnother point to Dr Cottrell: why would someone without clear symptoms commit to daily or weekly injections of uncertain benefit? What Prof G said about impact on cognition raises some issues: I know from personal experience that cognitive effects can appear before other signs of MS. The affected person may underperform at school or work. He may have a hard time keeping a job. He may be absent-minded or lethargic or confused. But so many people are like that! How to differentiate personal traits from the effects of MS, especially if these traits appear early in life.
Dr Cottrell focused on relapses. Prof G was more convincingTo some extent they were arguing at cross purposes: Dr Cottrell said we shouldn't treat RIS without evidence and prescription guidelines, and I very much doubt whether Prof G plans to go rogue and prescribe DMTs in cases of RIS Prof G's rejoinder to the point about costs and budgets wasn't entirely convincing. Yes, eventually the DMTs should come out of patent and become more affordable. But when? At the moment they're still exorbitantAnother point to Dr Cottrell: why would someone without clear symptoms commit to daily or weekly injections of uncertain benefit? What Prof G said about impact on cognition raises some issues: I know from personal experience that cognitive effects can appear before other signs of MS. The affected person may underperform at school or work. He may have a hard time keeping a job. He may be absent-minded or lethargic or confused. But so many people are like that! How to differentiate personal traits from the effects of MS, especially if these traits appear early in life.