Mirla Avila, MD, shares her perspective on how stability and a lack of changes in NMO is a good thing – even if we’d prefer to see improvement.
Transcript
Sometimes it’s easy to get stuck when things feel the same. But let’s remember that with a disease like NMO, not having a new or worsening symptom—staying the same—isn’t bad. It means we’re stable, especially if the MRI is stable and the patient is clinically stable.
It’s important for patients to understand that they may already have lasting effects from the disease. For example, someone might be diagnosed after losing vision in one eye, and that vision may not improve after treatment begins. The treatment goal is to prevent new lesions and new disability, but we may not be able to repair damage that has already occurred. I think it’s important for patients to be aligned with that reality.
Time can sometimes help: remyelination may occur, and symptoms can improve. But if that doesn’t happen, it doesn’t mean the medication has failed. It’s important to understand that the goal of treatment is to prevent new lesions from forming.
How do we know things are stable? They may feel boring, but that’s good. In the medical world, boring is actually good.
