Started my DMT (Tecfidera) with the NHS. It's classed as moderately effective, and honestly, I'm terrified it won't be enough—that by the time an MRI shows changes warranting something stronger like Kesimpta or Ocrevus, the damage will already be done. ​Mobility-wise, I'm on a crutch most of the time (neurophysiotherapist just gave me a second one), and things are gradually getting worse. ​I have a phone review with my MS specialist next week. For those who've been down this road, what clinical evidence or symptoms usually sway neurologists to step up to high-efficacy therapies earlier?