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@article{1725937, author = {Berger, Thomas and AdamczykandSowa, Monika and Csepany, Tunde and Fazekas, Franz and Fabjan, Tanja Hojs and Horakova, Dana and Ledinek, Alenka Horvat and Illes, Zsolt and Kobelt, Gisela and Jazbec, Sasa Sega and Klimova, Eleonora and Leutmezer, Fritz and Rejdak, Konrad and Rozsa, Csilla and Sellner, Johann and Selmaj, Krzysztof and Štourač, Pavel and Szilasiova, Jarmila and Turcani, Peter and Vachova, Marta and Vaneckova, Manuela and Vecsei, Laszlo and Havrdova, Eva Kubala}, article_location = {LONDON}, article_number = {DEC 2020}, doi = {http://dx.doi.org/10.1177/1756286420975223}, keywords = {biomarkers; burden of disease; cognitive dysfunction; magnetic resonance imaging; multiple sclerosis; neurofilament}, language = {eng}, issn = {1756-2856}, journal = {THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS}, title = {Factors influencing daily treatment choices in multiple sclerosis: practice guidelines, biomarkers and burden of disease}, url = {https://journals.sagepub.com/doi/pdf/10.1177/1756286420975223}, volume = {13}, year = {2020} }
TY - JOUR ID - 1725937 AU - Berger, Thomas - Adamczyk-Sowa, Monika - Csepany, Tunde - Fazekas, Franz - Fabjan, Tanja Hojs - Horakova, Dana - Ledinek, Alenka Horvat - Illes, Zsolt - Kobelt, Gisela - Jazbec, Sasa Sega - Klimova, Eleonora - Leutmezer, Fritz - Rejdak, Konrad - Rozsa, Csilla - Sellner, Johann - Selmaj, Krzysztof - Štourač, Pavel - Szilasiova, Jarmila - Turcani, Peter - Vachova, Marta - Vaneckova, Manuela - Vecsei, Laszlo - Havrdova, Eva Kubala PY - 2020 TI - Factors influencing daily treatment choices in multiple sclerosis: practice guidelines, biomarkers and burden of disease JF - THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS VL - 13 IS - DEC 2020 SP - 1-13 EP - 1-13 PB - SAGE PUBLICATIONS LTD SN - 17562856 KW - biomarkers KW - burden of disease KW - cognitive dysfunction KW - magnetic resonance imaging KW - multiple sclerosis KW - neurofilament UR - https://journals.sagepub.com/doi/pdf/10.1177/1756286420975223 L2 - https://journals.sagepub.com/doi/pdf/10.1177/1756286420975223 N2 - At two meetings of a Central European board of multiple sclerosis (MS) experts in 2018 and 2019 factors influencing daily treatment choices in MS, especially practice guidelines, biomarkers and burden of disease, were discussed. The heterogeneity of MS and the complexity of the available treatment options call for informed treatment choices. However, evidence from clinical trials is generally lacking, particularly regarding sequencing, switches and escalation of drugs. Also, there is a need to identify patients who require highly efficacious treatment from the onset of their disease to prevent deterioration. The recently published European Committee for the Treatment and Research in Multiple Sclerosis/European Academy of Neurology clinical practice guidelines on pharmacological management of MS cover aspects such as treatment efficacy, response criteria, strategies to address suboptimal response and safety concerns and are based on expert consensus statements. However, the recommendations constitute an excellent framework that should be adapted to local regulations, MS center capacities and infrastructure. Further, available and emerging biomarkers for treatment guidance were discussed. Magnetic resonance imaging parameters are deemed most reliable at present, even though complex assessment including clinical evaluation and laboratory parameters besides imaging is necessary in clinical routine. Neurofilament-light chain levels appear to represent the current most promising non-imaging biomarker. Other immunological data, including issues of immunosenescence, will play an increasingly important role for future treatment algorithms. Cognitive impairment has been recognized as a major contribution to MS disease burden. Regular evaluation of cognitive function is recommended in MS patients, although no specific disease-modifying treatment has been defined to date. Finally, systematic documentation of real-life data is recognized as a great opportunity to tackle unresolved daily routine challenges, such as use of sequential therapies, but requires joint efforts across clinics, governments and pharmaceutical companies. ER -
BERGER, Thomas, Monika ADAMCZYK-SOWA, Tunde CSEPANY, Franz FAZEKAS, Tanja Hojs FABJAN, Dana HORAKOVA, Alenka Horvat LEDINEK, Zsolt ILLES, Gisela KOBELT, Sasa Sega JAZBEC, Eleonora KLIMOVA, Fritz LEUTMEZER, Konrad REJDAK, Csilla ROZSA, Johann SELLNER, Krzysztof SELMAJ, Pavel ŠTOURAČ, Jarmila SZILASIOVA, Peter TURCANI, Marta VACHOVA, Manuela VANECKOVA, Laszlo VECSEI and Eva Kubala HAVRDOVA. Factors influencing daily treatment choices in multiple sclerosis: practice guidelines, biomarkers and burden of disease. \textit{THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS}. LONDON: SAGE PUBLICATIONS LTD, 2020, vol.~13, DEC 2020, p.~1-13. ISSN~1756-2856. Available from: https://dx.doi.org/10.1177/1756286420975223.
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