Three new things about multiple sclerosis presented at ECTRIMS 2017 are highlighted in this slideshow.
1. ECTRIMS Interview: http://www.touchneurology.com/gallery/ectrims-2017-jeffrey-cohen-interview2. Early treatment of multiple sclerosis. https://onlinelibrary.ectrims-congress.eu/ectrims/2013/copenhagen/38820/giancarlo.comi.ectrims.lecture.early.treatment.of.multiple.sclerosis.html?f=menu=14*media=3*speaker=553503. POSTER PS670: Relapse management in RRMS: real-world characteristics of steroid-treated patientshttps://onlinelibrary.ectrims-congress.eu/ectrims/2015/31st/115564/robert.j.fox.relapse.management.in.rrms.real-world.characteristics.of.html?f=menu=14*media=3*speaker=64998
Proposed 2017 Revisions to McDonald Criteria will allow for earlier diagnosis; provide a more specific diagnosis to better guide treatment; and are more inclusive of more patient subtypes. According to Jeffrey A Cohen, MD, “The intent is that an individual patient would be categorized, and then periodically reassessed as new data accumulate.”
The International Panel on Diagnosis of MS reviewed the original Lublin-Reingold classifications that maintained distinctions between relapsing remitting and progressive forms of MS and between disease that is progressive from onset and that which converts from relapsing-remitting to progressive. Two additional categories are proposed for 2017: Active vs Nonactive, based on the presence of recent clinical relapses or MRI lesion active; and progression vs nonprogression, based on whether the patient worsened gradually over the preceding period of time.
Expanded criteria to meet requirements for dissemination in space (at least 1 lesion in at least 2 locations): now includes cortical lesions as well as juxtacortical lesions. The distinction between symptomatic and asymptomatic lesions has been dropped.
Asymptomatic disease is destructive. Patients with CIS and an abnormal MRI scan are a high risk of developing MS.Risk is highest in the first 6 months following the first attack. Inflammatory activity in RRMS often starts before initial clinical relapse.
Early treatment may improve outcomes. Early, aggressive treatment may be even better.