Magd Zakaria presented a clinically oriented approach to integrating prognostic factors into early treatment decision-making in Multiple Sclerosis (MS). Building on current evidence and international guidelines, this keynote addresses a central question in MS management: how to balance early use of high-efficacy therapies with individual disease activity, patient characteristics, and healthcare system constraints.
Key Insights from the Lecture:
- Disability progression in MS is primarily driven by progression independent of relapse activity (PIRA), which begins early in the disease course.
- High-efficacy therapies have demonstrated greater impact on reducing PIRA compared with first-line treatments.
- Early use of high-efficacy therapies is associated with improved long-term disability outcomes.
- Not all patients require high-efficacy treatment at disease onset, particularly in cases of low disease activity.
- Current international guidelines still allow first-line therapies in patients with lower disease activity.
- Prognostic factors—demographic, clinical, radiological, and biological—are central to assessing disease activity and guiding treatment.
- Traditional approaches assign equal weight to prognostic factors, which does not reflect clinical reality.
- A novel scoring system was developed to assign differential weight to 14 clinically applicable prognostic factors.
- This model enables classification of patients into active, highly active, and aggressive disease categories.
- Economic considerations remain critical, particularly in low- and middle-income countries, requiring adaptable treatment strategies.
“Sphingosine system – Clinical aspects: available and future treatment“.
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About the speaker:
Magd Zakaria
Head of the Multiple Sclerosis Unit at the Ain Shams Specialized University Hospital
Magd Zakaria obtained his medical degree from the Medical School of Ain Shams University in 1980 where he graduated with honors. He completed his residency and obtained his Master’s Degree in Neuropsychiatry at the Neuropsychiatric Department of Ain Shams University in 1984. Prof. Zakaria became Assistant Lecturer in 1989 and thereafter obtaining his MD degree in Neurology in 1989. Prof. Zakaria became Assistant Professor of Neurology in 1994 and Professor of Neurology since 1999 until now. He was Head of the Neurology Department at the Ain Shams Specialized University Hospital in 1990 and Head of the Stroke Unit in 1991. Since 2014, Prof. Zakaria has become the Head of the Multiple Sclerosis Unit at the Ain Shams Specialized University Hospital.
Prof. Zakaria is currently the President of the Egyptian Society of Multiple Sclerosis and a member of the editorial board of the journal MSARD (Multiple Sclerosis and Related Disorders). He is also a member of the MENACTRIMS assembly board and Egypt’s Brain Health Champion (MS Brain Health Organization).
Prof. Zakaria was also the head of the Neuropsychiatric Department of the Ain Shams medical school from August 2015 till July 2017.
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