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Multiple Sclerosis — UKMLA MCQ

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HardNeurologyMultiple SclerosisUKMLAMRCP Part 1

A patient with relapsing-remitting MS has two disabling relapses despite a platform disease-modifying treatment. What is the next management principle?

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Correct answer: A — Reassess disease activity and escalate therapy with the specialist team

The best answer is “Reassess disease activity and escalate therapy with the specialist team”. Breakthrough relapses require specialist reassessment of adherence, diagnosis, MRI activity, comorbidity and pregnancy plans, followed by selection of a licensed higher-efficacy disease-modifying therapy when criteria are met. Corticosteroids treat relapses but do not provide long-term disease modification; escalation is not a one-size-fits-all primary-care prescription.

Reference: NICE NG220: Multiple sclerosis in adults — management: https://www.nice.org.uk/guidance/ng220/chapter/Recommendations