Managing High-Risk MS Patients: Safety, Treatment, and Emerging Strategies

In an interview with Pharmacy Times at the Consortium of Multiple Sclerosis Centers 2026, Stephanie Iyer, PhD, CPP, BCACP, a clinical pharmacist at University of North Carolina neurology clinic presenting on management of High-risk multiple sclerosis patients, discussed safety, treatment, and emerging strategies.

Iyer discussed key considerations surrounding the management of high-risk patients with MS, including early identification, treatment selection, safety concerns, and emerging strategies aimed at improving long-term outcomes.

During the discussion, Iyer explored how clinicians define “high-risk” MS patients and the clinical characteristics that may signal increased disease complexity or progression risk early in the treatment journey. The conversation highlighted the importance of recognizing factors that can influence both disease activity and therapeutic decision-making, particularly as the MS treatment landscape becomes increasingly complex.

Iyer also addressed one of the central challenges in modern MS care: balancing effective disease control with safety considerations in vulnerable patient populations. As higher-efficacy therapies continue to reshape treatment paradigms, clinicians are often tasked with navigating concerns related to infections, immunosuppression, comorbidities, and long-term tolerability while still aiming to minimize relapse activity and disability progression.

The interview additionally examined how therapy selection may differ in patients with elevated infection risk or significant underlying health conditions. Iyer discussed the need for individualized treatment approaches that account for both patient-specific risk factors and evolving evidence surrounding MS therapies.

Looking ahead, the discussion touched on emerging monitoring strategies and potential risk mitigation approaches that could help optimize care for high-risk MS populations. Topics included the growing interest in biomarkers, enhanced safety monitoring, and other evolving tools that may support earlier intervention and more personalized treatment management in the future.

Overall, the interview underscored the increasing complexity of treating high-risk MS patients and the importance of carefully balancing efficacy, safety, and individualized care strategies in a rapidly evolving therapeutic environment.