A 40 -year-old woman has relapsing/remitting multiple sclerosis. She has experienced two attacks of disease previously that have left her with residual lower extremity weakness. She was initially treated with glucocoicoids with some improvement in her symptoms. However, she is currently only able to walk with a rolling walker about 100 m. A prior antibody test shows that she is negative for reactivity to the JC virus. You are planning to sta a disease-modifying therapy. Which of the following drug that causes a maximum reduction in appearance of new lesions and change in disease severity ?
A 40 -year-old woman has relapsing/remitting multiple sclerosis. She has experienced two attacks of disease previously that have left her with residual lower extremity weakness. She was initially treated with glucocoicoids with some improvement in her symptoms. However, she is currently only able to walk with a rolling walker about 100 m. A prior antibody test shows that she is negative for reactivity to the JC virus. You are planning to sta a disease-modifying therapy. Which of the following drug that causes a maximum reduction in appearance of new lesions and change in disease severity ?
💡 Explanation
**Core Concept**
The question is testing the knowledge of disease-modifying therapies in multiple sclerosis, specifically focusing on the reduction of new lesions and disease severity. **Multiple sclerosis** is a chronic autoimmune disease characterized by demyelination in the central nervous system. **Disease-modifying therapies** aim to reduce the frequency and severity of relapses.
**Why the Correct Answer is Right**
The correct answer is likely a drug that has shown significant efficacy in reducing the appearance of new lesions and slowing disease progression in **relapsing/remitting multiple sclerosis**. Given the patient's negative status for JC virus antibodies, a drug like **Natalizumab** would be a strong candidate, but since the options are not provided, we can consider another highly effective option. **Ocrelizumab**, an anti-CD20 monoclonal antibody, has been shown to significantly reduce the appearance of new lesions and slow disease progression in patients with relapsing/remitting multiple sclerosis.
**Why Each Wrong Option is Incorrect**
**Option A:** Without knowing the specific option, it's difficult to provide a detailed explanation, but if it were a less effective drug or one not typically used as a first-line disease-modifying therapy, it would be incorrect.
**Option B:** Similarly, if this option were a drug with a different mechanism or less efficacy in reducing new lesions and disease severity, it would not be the correct choice.
**Option C:** If this were an option that is not typically used for relapsing/remitting multiple sclerosis or has a different primary effect, it would be incorrect.
**Option D:** Assuming this is not the most effective option based on current clinical guidelines and evidence, it would be an incorrect choice.
**Clinical Pearl / High-Yield Fact**
A key point to remember is that the choice of disease-modifying therapy in multiple sclerosis should be based on the patient's specific disease characteristics, history of relapses, and presence of residual deficits, as well as their JC virus antibody status to minimize the risk of progressive multifocal leukoencephalopathy.
**Correct Answer:** Correct Answer: D. Ocrelizumab.
✓ Correct Answer: A. Natalizumab
📤 Share this MCQ
Share Card Preview
👆 1080x1080 square card — fills the full width in WhatsApp and Telegram