Should multiple sclerosis be only treated by experts?

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system that affects more than 2.5 million patients worldwide. Dysregulation of the immune system is thought to be involved in MS, although the exact cause and pathogenesis remain elusive. While curative therapy is yet to be provided, more than ten disease-modifying drugs (DMD), mostly targeting the immune system, have been developed. Six DMDs are currently available in Japan. The modes of action are not completely understood for most DMDs. Thus, optimization of DMD treatment, according to the underlying pathology, is no easy task. MS experts select the most ideal DMD by balancing the drug efficacy and the risk, and may consider switching to other DMDs when the effect is suboptimal. The systemization of these processes is difficult. Knowing this, should MS be only treated by experts?.