Multiple sclerosis: clinical profiling and data collection as prerequisite for personalized medicine approach

Abstract

Multiple sclerosis (MS) is a highly heterogeneous disease as it can present inter-individually as well as intra-individually, with different disease phenotypes emerging during different stages in the long-term disease course. In addition to advanced immunological, genetic and magnetic resonance imaging (MRI) profiling of the patient, the clinical profiling of MS patients needs to be widely implemented in clinical practice and improved by including a greater range of relevant parameters as patient-reported outcomes. It is crucial to implement a high standard of clinical characterization of individual patients as this is key to effective long-term observation and evaluation.To generate reliable real-world data, individual clinical data should be collected in specific MS registries and/or using intelligent software instruments as the Multiple Sclerosis Documentation System 3D. Computational analysis of biological processes will play a key role in the transition to personalized MS treatment. Major breakthroughs in the areas of bioinformatics and computational systems biology will be required to process this complex information to enable improved personalization of treatment for MS patients.

Keywords: Multiple Sclerosis Documentation System; Multiple sclerosis; Personalized medicine.

Fig. 1

Two-dimensional functional disability scale (2D FDS) including clinical and subclinical measures representing both the patient’s and the physician’s perspectives in MSDS3D

Fig. 2

Combining individual treatment and big data RWE approach as a combined treatment approach: Individual clinical profiling is essential to characterize the individual patient in detail which is essential for individual treatment decisions. On the other side, collecting all individual patients profiles using big data approach can predict disease course and treatment responses again making personalized medicine possible

Fig. 3

a MSDS3D as interdisciplinary platform to manage MS patients using the MSDS3D cloud connected with devices (b) MSDS3D as both local and web-based data entry system using module- and task box based technology and the MS overview

Fig. 4

Profiling patients and collecting data. As part of the personalized medicine approach, MS patients should be characterized by a detailed clinical profiling which is the base of all long-term documentation. All patients should be documented during the course of the disease to understand treatment response, document relapses and disease progression as well as quantitative inflammatory and neurodegenerative magnetic resonance imaging (MRI) markers. Physician- and patient-centered parameters should be collected by intelligent software systems as MSDS software. MS big data can be used to analyze treatment response patterns and allow personalized treatments. Therefore, the available information (big data MS) of all included MS patients can assist in complex treatment decisions in future

Fig. 5

Predictive modelling in MS allowing patient controlled and software based approach in contrast to traditional approaches