December 20, 2023

Research transforms care for people with multiple sclerosis

Our researchers are leading the way to more effective, affordable, and equitable care.

Annette Langer-Gould, MD, PhD, studies treatments to improve care for people with MS. Jacques Roussel is a patient partner in one of her studies.

Treatment for multiple sclerosis needs to change. At Kaiser Permanente, it already has.

We’ve improved care thanks to research conducted by Annette Langer-Gould, MD, PhD, and her colleagues.

Dr. Langer-Gould wants the rest of the world to follow. She co-authored an article in the journal Neurology urging the medical community to adopt use of a medication that has the potential to improve care for many patients.

Dr. Langer-Gould, a neurologist and a scientist who studies MS, discusses what she’s learned through her research.

What is MS?

MS is a disease that affects the brain and spinal cord, often leading to permanent disability. It cannot be cured. But medications can help reduce the risk of disability.

Nearly a million people in the United States have MS. For most people, the disease starts with a rather sudden onset of symptoms. Those symptoms may go away or lessen with time. If new symptoms appear or old symptoms return for a period of time, it’s called a relapse.

Why does MS treatment need to change?

People with more aggressive MS benefit from stronger drugs. However, in the United States, many people can’t afford the copays. Sometimes people don’t get the treatment they need and become disabled.

At Kaiser Permanente in Southern California, our Multiple Sclerosis Treatment Optimization Program ensures that more people with relapsing MS receive highly effective drugs as early in the disease course as possible.

Key to the program is our increased use of a drug called rituximab. This drug is more traditionally used for cancer and other diseases. But evidence shows it’s safe and highly effective for relapsing MS. And it costs much less than other options.

Many insurance carriers in the United States and Europe limit coverage of rituximab for treating MS. They’ve cited a lack of regulatory approval for use of the drug to treat MS. But that may be changing.

The World Health Organization now lists rituximab as an essential drug for MS. I hope other organizations will follow. Wider use could have significant benefits for patients and could reduce inequities.

How has your research led you to push for a shift?

A study we published in 2022 found that MS relapse rates plummeted for Kaiser Permanente members in Southern California during the initial rollout of our program. Thanks in part to the lower cost of rituximab, the cost of treatment has fallen.

And patients say they love rituximab. Besides being effective and affordable, it’s long-lasting, so they don’t need to come to the office as often. That means more people tend to stick with treatment over time.

What’s more, research in Sweden showed similar benefits of rituximab for patients. The country’s health care system has now approved it for MS. It really seems to be a game changer.

What drew you to study MS?

I began seeing MS patients as a medical resident and PhD student. It’s a chronic disease, so it gave me an opportunity to build rewarding, long-term relationships with patients. I also realized studying MS would be a chance to fight for underserved patients.

Our success with MS highlights Kaiser Permanente’s use of evidence-based medicine. We’re improving care based on evidence gathered through our research. And we hope the rest of the country follows our lead.