Change from platform to high efficacy disease-modifying treatment for multiple sclerosis despite NEDA

We report the case of a relapsing multiple sclerosis (RMS) patient, who, in light of the recent insights demonstrating the potential of high-efficacy disease modifying treatments (heDMT) to delay secondary progression, requested changing her platform therapy despite having currently no evidence of disease activity and a favourable neurofilament light chain serum concentration (sNfL). After changing to a heDMT, her EDSS and cognitive scores improved and her sNfL decreased further. Changing from platform to heDMT should be an available option for RMS patients wishing to maximize their brain health on the long-term.