For Proper Diagnosis and Treatment of MS, Time is of the Essence

A group of researchers found that people with multiple sclerosis (MS) often endure delays before seeing a neurologist, and that initiatives are necessary to improve access to services and professionals. The authors were led by Gavin Giovannoni, of Queen Mary University London, Blizard Institute, Barts and The London School of Medicine and Dentistry, UK, and their article was published on the website of the journal Multiple Sclerosis and Related Disorders on July 7, 2016.

The researchers conducted structured discussions and examined the literature to create international consensus recommendations for how physicians diagnose, manage, and treat patients with multiple sclerosis (MS). “Our vision is that the report and its recommendations will be used widely among those committed to creating a better future for people with MS and their families,” said the researchers.

One of the most critical findings of the report is that there is a need for urgency when it comes to MS. The authors say that “Even in the early stages of MS, cognition, emotional well-being, quality of life, day-to-day activities and ability to work can be markedly affected by the damage occurring in the brain and spinal cord.”

Even though MS is diagnosed 10 times faster now than in the 1980s, the researchers report, “Significant delays often occur before a person with symptoms suggestive of MS sees a neurologist for diagnosis and treatment.” The authors recommend awareness campaigns for both the general public and for clinicians in order to improve outcomes through earlier diagnosis.

Early intervention allows patients and doctors to work together toward appropriate lifestyle changes, treatment that can reduce disease activity, and treatment monitoring. “Involving people with MS proactively in decision-making and in managing their disease is also key to the successful management of MS” the researchers say.

“Regular monitoring of disease activity and recording this information formally are the cornerstone of the strategy recommended by the authors,” they say, adding that this will allow for personalized treatment and “will generate long-term real-world evidence” that can be used to evaluate therapies.

Another advantage to closely monitoring MS is that it will allow clinicians and patients to decide quickly to switch therapies if one treatment is ineffective. However, the researchers found that “access to therapies is limited by licensing stipulations, prescribing guidelines or reimbursement decisions” and the full range of treatments is not available to all patients. They recommend that all parties involved work to improve access to therapeutic strategies.

Finally, the researchers call for “major policy changes in order to translate recent advances in the diagnosis and treatment of MS into improved outcomes.” Following the recommendations of this paper could, according to the researchers, “avoid many of the long-term economic and personal costs that result from unnecessary irreversible disability.”