Optimizing outcomes in multiple sclerosis - A consensus initiative

Journal Article (Journal Article)

Background: Initiation of immunomodulators in patients experiencing a clinically isolated syndrome (CIS) may delay progression to clinically definite MS. However, lack of consensus remains on many issues affecting optimal management of MS. Method: A panel of 21 MS experts met during 9 meetings to explore key issues in MS and CIS. Meetings addressed 3 phases: 1. CIS definition and diagnosis; 2. initial therapy; and 3. monitoring disease progression and treatment efficacy. Newsletters covering each phase were sent to 5000 U.S.-based neurologists who were invited to participate in an online survey on key issues. Results: Most panel members agreed that early treatment may minimize neurodegeneration and most would recommend it for patients; that a dose-response relationship exists for beta-interferon therapy; that more aggressive therapy was most effective early in the disease course; and, that MRI has a role in monitoring disease progression. In face of suboptimal response, most would switch patients to a different therapy; while combination therapy would be reserved for those failing monotherapy regimes. Most online survey respondents agreed with these positions. Conclusions: There was uniform consensus from this panel of MS experts that early initiation of immunomodulator therapy was beneficial for CIS patients.

Full Text

Duke Authors

Cited Authors

  • Coyle, P; Arnason, B; Hurwitz, B; Lublin, F

Published Date

  • April 27, 2009

Published In

Volume / Issue

  • 15 / SUPPL. 2

International Standard Serial Number (ISSN)

  • 1352-4585

Digital Object Identifier (DOI)

  • 10.1177/1352458508101134

Citation Source

  • Scopus