MS Classification and Impact on Care

In this episode, the panelists address the challenges inherent in diagnosing and categorizing multiple sclerosis (MS), emphasizing the limitations of the traditional “binning” approach that relies on rigid phenotypes. Clinical experiences are shared where patients frequently seek definitive answers about their MS type, but biological markers do not neatly align with these categories, resulting in delays in identifying secondary progression. It is noted that progression is often diagnosed based on ambulation difficulties, which can be arbitrary and may cause essential changes in care to be postponed. The subjective nature of clinicians’ assessments and patients’ recollections further complicates classification and highlights flaws within the current system. Following this, one expert comments that their treatment strategy is not guided by strict classification but rather by approaching MS as a continuum. The perspective shared is that all patients are potentially progressive and should receive aggressive, individualized early treatment aimed at slowing disease progression from the outset.