changing because if MRI’s change, that eventually leads to changes in the person. So MS is a little bit of a different disease because we do actually treat people or change their treatment if their test results or MRI images change.
Most of the time we say that we don’t make treatment decisions based on tests, but in this case, we do. And so we’re trying to affect the person in terms of we don’t want them having those relapses, those episodes of symptoms that come and go. And then we don’t want them having progression. We don’t want them getting worse slowly over time as much as possible. So we’re trying to affect the MRI and we’re trying to affect the patient.
The one thing that I didn’t say is that we can’t affect, at least with our disease-modifying therapies, the symptoms that are already there, so we can’t, with the medicines we use to treat MS, fix what’s already broken, but our goals are to try to prevent new things from being broken and that’s something that I spend a very long time on explaining to patients because it is very different from how we traditionally think of medicines, right?
If we have a headache, we take this medicine, we expect it to get better. If we have diabetes and we take this medicine, we expect the sugar to come down with MS. The drugs are really preventative, so if you have numbness and we start you on a disease-modifying therapy for MS, it’s not going to affect that numbness. Okay? But we hopefully want to prevent you from having more numbness or numbness in different places. There are other medications that we can use to treat some of those symptoms, but we have to make sure that we’re very clear about our expectations with disease-modifying therapies or people would get discouraged and stop taking their medications because of that.
I like to think of MS Treatment as a four-layer cake because I like cake and the four layers represent the different approaches that we have to treatment. So the first layer is what I call relapse management. So that’s when someone comes in with that acute symptom. Let’s say, Dr. Williams, “I can’t see out of one eye.” There are medicines that we