Timing Matters: The Role of Biologic and Infusion Therapies in Slowing MS Progression

Over the past two decades, biologic and infusion-based disease-modifying therapies (DMTs) have fundamentally reshaped the MS treatment paradigm, enabling earlier intervention, deeper suppression of inflammatory activity, and more durable disease control. As therapeutic potency has increased, so has recognition that outcomes are influenced not only by medication selection, but also by timely and consistent administration. Reliable, in-office biologic and infusion delivery plays a central role in ensuring treatment timing aligns with clinical intent.

What to Know

• Earlier initiation of high-efficacy MS therapies is associated with less long-term disability.
• More intensive early treatment strategies are associated with better relapse and disability outcomes than escalation-first approaches in real-world cohorts.
• Delays and interruptions can increase the risk of breakthrough disease activity and reduce patient confidence.
• Therapy transitions are a high-risk period for gaps in MS care.
• Altus Biologics helps neurology practices deliver biologics and infusions reliably in-office so treatment timing matches clinical intent.

Why Timing Is Clinically Critical in MS

MS injury begins early, often before significant disability is apparent. Inflammatory lesions and axonal damage accumulate over time, and once lost, neurologic function cannot be fully restored. Consistent, on-time biologic and infusion therapy is therefore a key factor in slowing cumulative disease progression.

Evidence from large registries and comparative effectiveness research supports the importance of early, high-efficacy treatment. For example, a retrospective observational cohort study published in The Lancet Neurology found that initiating high-efficacy therapy within 2 years of disease onset was associated with less disability at 6-10 years than initiating therapy later.

Timely therapy delivery is therefore not only an operational metric but also a clinical determinant of the long-term disease trajectory.

In practical terms, timing matters at three levels:

• Early initiation after diagnosis or early disease activity
• On-schedule dosing
• Seamless transitions between therapies

Breakdowns at any of these points can compromise outcomes.

The Hidden Risk of Delays and Interruptions

Delays rarely present as a single obvious failure. More often, they accumulate due to authorization backlogs, scheduling bottlenecks, limited infusion capacity, external site availability constraints, and communication gaps among the practice, payer, and site of care.

For patients, even short delays can feel significant. Postponed infusions may increase anxiety, reduce confidence in treatment, and create uncertainty about disease control. Over time, that erosion of trust can affect adherence and engagement.

Therapy Transitions Are a High-Risk Period

Switching MS therapies is increasingly common as clinicians escalate to higher-efficacy agents, manage adverse effects, or respond to ongoing disease activity. These transitions require precise coordination, including appropriate washout timing, timely payer approval, and continuous monitoring.

Any gap between discontinuation of one therapy and initiation of the next increases vulnerability to relapse or disease reactivation.

These transition-related vulnerabilities are not merely logistical. They reflect a broader question about treatment strategy. Approaches that rely on prolonged stepwise escalation inherently expose patients to more therapy changes, more handoffs, and more opportunities for interruption. National-level registry data support the clinical value of initiating more effective therapies earlier rather than relying on slower escalation pathways.

In-Office Administration: Aligning Operations with Clinical Intent

In-office biologic and infusion programs give neurology practices direct oversight of the treatment pathway, from ordering through administration and follow-up, reducing reliance on external sites with limited visibility into the patient’s broader care plan.

Greater scheduling control, consistent nursing protocols, and real-time communication enable practices to respond promptly to delays and maintain therapy alignment with prescribing intent.

Altus Biologics partners with neurology practices to design, launch, and operate in-office biologic and infusion services that support consistent, on-time therapy.

Through workflow optimization, staffing and training support, reimbursement expertise, and logistics management, Altus helps create a scalable infusion infrastructure that preserves continuity.

When therapy is delivered as intended, patients experience fewer gaps, and practices maintain confidence that treatment plans are being executed accurately.

Frequently Asked Questions

Why does early treatment matter in MS?

Earlier initiation of effective therapy is associated with better long-term outcomes, including less accumulation of disability in observational cohorts.

What happens if a patient misses or delays an infusion?

Delays can increase the risk of breakthrough disease activity and reduce patient confidence in disease control, especially if they become recurrent.

Why are therapy transitions especially risky?

Transitions can introduce gaps due to washout requirements, authorization timing, and site-of-care logistics. Even short interruptions can leave patients temporarily under-covered.

Does in-office infusion improve adherence?

Yes. Direct scheduling control, integrated communication, and consistent staffing can reduce missed appointments and support continuity.

How does Altus Biologics support neurology practices?

Altus provides the operational infrastructure and infusion program support needed to deliver biologics and infusions reliably in-office, so timing aligns with clinical intent.