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• W2473370718 abstract "ObjectiveWe present international consensus recommendations for improving diagnosis, management and treatment access in multiple sclerosis (MS).BackgroundDisease understanding, diagnostic criteria, treatment options and monitoring procedures in MS are rapidly evolving.MethodsStructured discussions and literature searches conducted in 2015 examined the personal and economic impact of MS, current practice in diagnosis, treatment and management, definitions of disease activity and barriers to accessing disease-modifying therapies (DMTs).ResultsDelays often occur before a person with symptoms suggestive of MS sees a neurologist. Campaigns to raise awareness of MS are needed, as are initiatives to improve access to MS healthcare professionals and services.We recommend a clear treatment goal: to maximize neurological reserve, cognitive function and physical function by reducing disease activity. Treatment should start early, with DMT and lifestyle measures. All parameters that predict relapses and disability progression should be included in the definition of disease activity and monitored regularly when practical. On suboptimal control of disease activity, switching to a DMT with a different mechanism of action should be considered. A shared decision-making process that embodies dialog and considers all appropriate DMTs should be implemented. Monitoring data should be recorded formally in registries to generate real-world evidence.In many jurisdictions, access to DMTs is limited. In the 14 countries examined, the proportion of people with MS receiving a DMT in 2013 was in the range of 13-69[percnt]. To improve treatment access the relevant bodies should consider all costs to all parties when conducting economic evaluations and encourage the continuing investigation, development and use of cost-effective therapeutic strategies and alternative financing models.ConclusionsThe consensus findings of an international author group recommend a therapeutic strategy based on proactive monitoring and shared decision-making in MS. Early diagnosis and improved treatment access are also key components. Disclosure: Dr. Giovannoni has received personal compensation for activities with AbbVie Biotherapeutics Inc., Biogen, Bayer HealthCare, Genzyme, Merck Serono, Sanofi-Aventis, Teva, Ironwood, and Novartis. Dr. Butzkueven has received personal compensation for activities with Novartis, Merck Serono, and Biogen Idec as a consultant and/or advisor. Dr. Dhib-Jalbut has received research support from Teva Neuroscience and Biogen Idec. Dr. Hobart has received (royalty or license fee or contractual rights) payments from Plymouth University. Dr. Kobelt has received personal compensation for activities with Novartis, Biogen, Genzyme, and Oxford PharmaGenesis as a consultant. Dr. Pepper has received personal compensation for activities with Oxford PharmaGenesis. Dr. Sormani has received personal compensation for activities with Novartis, Roche, Genzyme, Merck Serono, TEVA, Synthon, and Biogen Idec as a consultant and speaker. Dr. Thalheim has received personal compensation for activities with Almirall, Biogen, Novartis, GSK, Roche and Oxford PharmaGenesis. Dr. Traboulsee has received personal compensation for activities with Genzyme and Roche. Dr. Traboulsee has received research support from Genzyme, Roche, Chugai. Dr. Vollmer has received personal compensation for activities with Acorda Therapeutics, Biogen Idec, Genentech, Inc., Novartis, Ono Pharmaceutical, Teva Neuroscience, and XenoPort as a consultant." @default.
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• W2473370718 date "2016-04-05" @default.
• W2473370718 modified "2023-09-23" @default.
• W2473370718 title "Time Matters in Multiple Sclerosis - International Consensus Recommendations on Diagnosis, Management and Treatment Access (P1.340)" @default.
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