This Spain-based key opinion leader (KOL) opines on the current treatment approach in multiple sclerosis (MS). The KOL discusses patient classification by phenotype and disease activity, covering relapsing-remitting, secondary progressive (SPMS), and primary progressive MS (PPMS). The KOL outlines prescribing trends across therapy classes, from platform therapies and S1P modulators to anti-CD20 agents, highlighting the dominant role of ocrelizumab and ofatumumab, and the growing use of ublituximab despite administrative hurdles. The KOL elaborates on off-label rituximab use, biosimilar natalizumab uptake, and compliance challenges with oral therapies. The KOL also discusses the anticipated launch of BTK inhibitors, particularly tolebrutinib, fenebrutinib, and remibrutinib, examining their differentiated safety profiles, patient populations, and potential market share impact. The KOL further addresses unmet needs, emphasising remyelination as the key gap, and evaluates pipeline therapies including vidofludimus calcium, frexalimab, and CAR-T cell therapy. Comparisons with MS treatment practices in Germany and Italy are also offered.  

This interview was conducted on February 18, 2026. 

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