Overview of the management of relapsing-remitting multiple
sclerosis and practical recommendations
The initial phases of the clinical course of relapsingremitting multiple sclerosis (MS) are characterized by a mainly inflammatory pathology which gives way to a largely neurodegenerative process as the disease evolves. As all currently available disease-modifying therapies aim to control inflammation, the window of opportunity for use is early in the disease course, specifically at the time of a clinically isolated syndrome suggestive of MS or in the early stages of relapsingremitting MS. Approximately 30% of patients treated with firstline immunomodulators (interferon-b or glatiramer acetate) show a suboptimal response during the first 1–2 years and require a switch to an alternative therapy. It is recommended not to wait too long to switch in order to prevent disease progression. Patients with a poor prognosis in particular may require a timely switch to a second-line agent. Regular monitoring of disease and therapy in patients with MS is essential. In the first year after diagnosis, clinical evaluations (neurological status, symptomatic assessment, patient well-being) should be performed at baseline, 3, 6 and 12 months, and then every 6 months thereafter. Brain magnetic resonance imaging (MRI) should be performed every 6 months in the first year of treatment, and at least once yearly thereafter. A spinal cord MRI should be performed once yearly in patients presenting spinal symptoms.
Source: European Journal of Neurology 2015, 22 (Suppl. 2): 14–21
Minimum two MS experts collaborate to produce an educational slide deck. These slide decks are presented (live) to ParadigMS members, peer reviewed and updated.
The slide decks are published on the ParadigMS website “on behalf of ParadigMS”.
Based on the slide decks, publications are produced. These publications are peer reviewed and published as consensus publications.
Regional (fe: Scandinavian countries, Benelux, …) or national events where state-of-the-art science is transferred to general neurologists and other care givers (nurses, etc) that are confronted with MS in their day to day practice.
Webinars can complement the educational events.
The educational slide decks, events and webinars can be important building blocks of accredited educational programs.