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January 15, 2019

Potential Benefits of Early Aggressive Treatment in Multiple Sclerosis

Author Affiliations
  • 1Department of Neurology, University of California, San Francisco Weill Institute for Neurosciences
  • 2Department of Ophthalmology, University of California, San Francisco
  • 3Associate Editor, JAMA Neurology
JAMA Neurol. 2019;76(3):254-256. doi:10.1001/jamaneurol.2018.4932

“Our doubts are traitors,
and make us lose the good we oft might win,
by fearing to attempt.”

William Shakespeare, Measure for Measure

“Optimism, not pessimism, is needed in medicine; not, however, the optimism that takes up each new fad to the exclusion of old and tried measures, but the kind that begets hopefulness and confidence.”

Minor Comments. JAMA. 1901: 36

The brain is arguably the most precious organ in the body. Yet neurologists have a reputation for cautious implementation of therapeutic advances, sometimes verging on excessive hesitancy. Many in the field focus on the potential for therapeutic harm and question the significance of therapeutic benefits, especially when those benefits are measured in outcomes other than those that would most obviously be considered preeminent.