Has anyone here started straight with high-efficacy treatment (ocrevus, kesimpta or Tysabri) while not yet having accrued any disability and only few lesions in the brain? I am reading quite a few opinions and studies indicating it might be better to hit MS hard and early. In my case (36F) I have 3 lesions in my brain and I had mild optic neuritis with RRMS diagnosis (positive bands in spinal fluid) some vertigo spells in the past. My neurologists seem to lean towards tecfidera with medium efficacy and a less risky side effect profile but I am leading towards an infusion therapy. I am looking for some perspectives and experience from people who have chosen to go straight to high efficacy drugs and how it’s going for you. Any advise or experienced you can share in favor or against this approach? EDIT: Thanks for everyone's comments here. I just had the discussion with the neurologists on medication, and we agreed that Ocrevus is an excellent choice of drug, they fully support this decision with the reasoning I gave: studies show that easy use of high-efficacy drugs leads to the best outcomes in terms of disability progression.