Q&A with Dr Timothy Vollmer, leading MS Neurologist

Blue Latitude Health|11th December 2018

Multiple Sclerosis (MS) impacts more than 2.3 million people across the globe with 200 new patients diagnosed each week.

However, while MS is a common disorder, little is known about why it occurs, and many doctors are still confused about the different phases of the disease which manifest in relapse, remitting and progressive forms.

One of the driving challenges is the diverging treatment approaches taken by neurologists. These healthcare professionals are locked in a debate about how quickly to turn to the innovative new drugs.

While some specialists are prescribing the newer therapies first, in a bid to drive improved and sustainable patient outcomes, other doctors are taking the traditional route of using less-efficacious therapies early on. However, evidence has come to light that could settle this debate once and for all.

"We could change the outcome of MS in one generation, from a disease that almost always disabled people to a disease that very rarely disables people"

Dr Timothy Vollmer has spent the last 30-years treating patients with MS. He has worked on more than 100 MS clinical studies. Additionally, his roles as Director of Neurosciences Clinical Research at the University of Denver, Medical Director of the Rocky Mountain Multiple Sclerosis Center, and Co-Director of the RMMSC at Anschutz, place him at the cutting edge of MS treatment.

He has been awarded numerous accolades, including winning a place on Castle Connolly’s list of America’s top doctors, being ranked in the top 1% of neurologists in the US News & World Report and gaining a seat in the National Multiple Sclerosis Society Volunteer Hall of Fame – to name a few.

Interestingly Vollmer’s mission is not to slow down the progression of MS, instead he is determined to stop it in its tracks. An outcome he claims is achievable today for a majority of patients, if neurologists were better informed about the treatment options available.

Blue Latitude Health sat down with him to learn about two very different treatment approach taken by doctors, along with the barriers and common misconceptions that prevent neurologists from using innovative treatments to halt the progress of MS.

Why did you first want to become an MS neurologist?

TV: My aunt died of MS when I was a child. Then, when I went to medical school, I was interested in neurology but I found I was best at immunology. If you combine those two, the most common disease in that area is MS. It’s personal but it’s also based on scientific skills and comfort.

In the past five years have you seen a shift in the way MS patients are diagnosed and treated?

Yes and no. Unfortunately, the approach to multiple sclerosis is a patchwork landscape. There are pockets of practitioners in certain geographic regions who tend to use old therapies and only move to the newer therapies when patients fail in some way.

The thing is, failure is not really defined – it could be that a patient has too many relapses for that particular physician, or they’ve got a lot worse in terms of disability, or they’re having trouble with side effects, or it could be something else. The predominant drugs prescribed in the world are still interferons.

However, in the last six or seven years, in my opinion, we’ve had much better therapies that can fundamentally change the outcomes of MS. Since 2016 some very good therapies have emerged. In the vast majority of cases, these drugs can stop the disease and allow patients to improve, particularly if they’re in the relapse/ remitting phase. The therapies allow them to recover function and it’s not uncommon for patients to report they feel like they don’t have MS on a daily basis.

Why are some doctors still treating with less efficacious drugs first?

Interferons have been around for a long time and neurologists have become cavalier in their use. They think they’re totally safe but they’re not. Both interferons and the newer drugs have rare but serious side effects.

Then there is the emotional trauma for patients dealing with those agents and having to have regular injections – it fundamentally changes their MS experience. On top of that, their symptoms don’t go away. They may have fewer relapses, but they continue to move into the next phase of the disease – the drugs just slow things down. In healthcare systems, there’s also a common misconception that the older drugs are cheaper but they’re not.

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