skip to main content

MS – Treatment Escalation from Platform Therapy — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardMultiple Sclerosis & CNS InflammationMS – Treatment Escalation from Platform TherapySCE Neurology

A 38-year-old with relapsing-remitting multiple sclerosis has two disabling relapses and four new T2 lesions over 12 months while adherent to dimethyl fumarate. Lymphocyte count is normal and disability remains ambulatory. What is the best disease-modifying strategy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Escalate to higher-efficacy therapy through the specialist MS MDT

Clinical relapses plus new MRI lesions demonstrate breakthrough inflammatory disease. Current NHS England and ABN strategy supports timely escalation, with the MS MDT matching a higher-efficacy agent to comorbidity, pregnancy plans, infection risk and patient preference. Waiting for fixed disability, adding monthly methylprednisolone, lateral platform switching and untreated observation expose the patient to avoidable inflammatory injury.

Reference: NHS England treatment algorithm for multiple-sclerosis disease-modifying therapies (Published June 2026): https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2026/06/treatment-algorithm-for-multiple-sclerosis-disease-modifying-therapies-june-2026.pdf; Association of British Neurologists 2024 guidance on multiple-sclerosis disease-modifying treatments (Published 2024; current ABN guidance): https://doi.org/10.1136/pn-2024-004228