Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 28:13:931014.
doi: 10.3389/fneur.2022.931014. eCollection 2022.

Consensus on early detection of disease progression in patients with multiple sclerosis

José E Meca-Lallana  1 , Bonaventura Casanova  2 , Alfredo Rodríguez-Antigüedad  3 , Sara Eichau  4 , Guillermo Izquierdo  5 , Carmen Durán  6 , Jordi Río  7 , Miguel Ángel Hernández  8 , Carmen Calles  9 , José M Prieto-González  10 , José Ramón Ara  11 , Dionisio F Uría  12 , Lucienne Costa-Frossard  13 , Antonio García-Merino  14 , Celia Oreja-Guevara  15
Affiliations

Consensus on early detection of disease progression in patients with multiple sclerosis

José E Meca-Lallana et al. Front Neurol. .

Abstract

Background: Early identification of the transition from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS) can be challenging for clinicians, as diagnostic criteria for SPMS are primarily based on physical disability and a holistic interpretation.

Objective: To establish a consensus on patient monitoring to identify promptly disease progression and the most useful clinical and paraclinical variables for early identification of disease progression in MS.

Methods: A RAND/UCLA Appropriateness Method was used to establish the level of agreement among a panel of 15 medical experts in MS. Eighty-three items were circulated to the experts for confidential rating of the grade of agreement and recommendation. Consensus was defined when ≥66% agreement or disagreement was achieved.

Results: Consensus was reached in 72 out of 83 items (86.7%). The items addressed frequency of follow-up visits, definition of progression, identification of clinical, cognitive, and radiological assessments as variables of suspected or confirmed SPMS diagnosis, the need for more accurate assessment tools, and the use of promising molecular and imaging biomarkers to predict disease progression and/or diagnose SPMS.

Conclusion: Consensus achieved on these topics could guide neurologists to identify earlier disease progression and to plan targeted clinical and therapeutic interventions during the earliest stages of SPMS.

Keywords: consensus; disease progression; early detection; multiple sclerosis; secondary progressive multiple sclerosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following potential conflicts of interest regarding the research, authorship, and/or publication of this article: JM-L has received grants and consulting or speaking fees from Almirall, Biogen Idec, Celgene, Genzyme, Merck, Novartis, Roche, and Teva. BC has received research support or personal compensation from any commercial entity (for-profit business) for employment, consulting, serving on a scientific advisory board, speaking, or other activities from Biogen, Sanofi, Roche, Merck, Teva, Novartis, Celgene, and Almirall. AR-A has received personal compensation from any commercial entity (for-profit business) for serving on a scientific advisory board or speaking from Merck, Biogen Idec, Roche, Genzyme, Teva, Mylan, and Celgene. SE has received speaker honoraria and consultant fees from Biogen, Novartis, Sanofi Genzyme, Merck, Almirall, Roche, and Teva. GI has received speaking and/or advisory board honoraria from Bayer, Biogen Idec, Novartis, Sanofi, Merck Serono, Almirall, Roche, Actelion, Celgene, and Teva. CD has received speaking and/or advisory board honoraria from Sanofi, Novartis, AbbVie, and Bial. JR has received speaking honoraria and personal compensation for participating on advisory boards from Biogen Idec, Genzyme, Merck Serono, Novartis, Teva, and Sanofi-Aventis. MH has received research support or personal compensation from any commercial entity (for-profit business) for employment, consulting, serving on a scientific advisory board, speaking, or other activities from Biogen, Novartis, Roche, Merck, Teva, and Genzyme-Sanofi. CC has received personal compensation from any commercial entity (for-profit business) for employment, consulting, serving on a scientific advisory board, speaking, or other activities from Teva, Sanofi-Genzyme, Merck, Novartis, Biogen, and Roche. JP-G is a consultant for Bayer, Biogen Idec, Genzyme, Merck Serono, Novartis, Sanofi-Aventis, Teva, Roche, and Almirall. He has participated as a speaker/moderator in meetings and/or symposia organized by Almirall, Bayer, Biogen Idec, Genzyme, Merck Serono, Novartis, Sanofi-Aventis, Teva, and Roche. He has received grants for research projects from Almirall, Biogen Idec, Novartis, and Sanofi-Genzyme. JA has received honoraria for lecturing, travel expenses for attending meetings, or financial support for research from Biogen Idec, Merck Serono, Genzyme, and Novartis. DU has received honoraria for lecturing, courses, advisory boards, or financial support for research from Biogen, Merck, Novartis, Roche, Sanofi, Teva, Bayer, and Almirall. LC-F has received honoraria for lecturing, travel expenses for attending meetings, or financial support for research from Merck, Bayer, Biogen, Novartis, Sanofi-Genzyme, Almirall, Roche, Celgene, Biopas, Ipsen, and Teva. AG-M has received compensation for lecturing, scientific advisory board and consulting from Novartis, Merck, Roche, Emerald, Biogen and Sanofi, and research support from Teva. CO-G has received honoraria for speaking and/or consultancy from Biogen, Sanofi-Genzyme, Merck, Roche, Teva, and Novartis.

Figures

Figure 1
Figure 1
Likert scales used to rate the statements.
See this image and copyright information in PMC

References

    1. Reich DS, Lucchinetti CF, Calabresi PA. Multiple sclerosis. N Engl J Med. (2018) 378:169–80. 10.1056/NEJMra1401483 - DOI - PMC - PubMed
    1. Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sorensen PS, Thompson AJ, et al. . Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. (2014) 83:278–86. 10.1212/WNL.0000000000000560 - DOI - PMC - PubMed
    1. Fambiatos A, Jokubaitis V, Horakova D, Kubala Havrdova E, Trojano M, Prat A, et al. . Risk of secondary progressive multiple sclerosis: a longitudinal study. Mult Scler. (2020) 26:79–90. 10.1177/1352458519868990 - DOI - PubMed
    1. Koch M, Kingwell E, Rieckmann P, Tremlett H. The natural history of secondary progressive multiple sclerosis. J Neurol Neurosurg Psychiatry. (2010) 81:1039–43. 10.1136/jnnp.2010.208173 - DOI - PubMed
    1. Cree BA, Gourraud PA, Oksenberg JR, Bevan C, Crabtree-Hartman E, Gelfand JM, et al. . Long-term evolution of multiple sclerosis disability in the treatment era. Ann Neurol. (2016) 80:499–510. 10.1002/ana.24747 - DOI - PMC - PubMed