The Canadian MS Working Group (CMSWG) — made up of neurologists with the Canadian Network of MS Clinics — has updated its recommendations concerning diagnosis and the use of disease-modifying therapies (DMTs) for multiple sclerosis (MS), according to a press release from the MS Society of Canada.
The 16 new recommendations contained in “Treatment Optimization in Multiple Sclerosis: Canadian MS Working Group Recommendations” were published in the Canadian Journal of Neurological Sciences.
CMSWG last released guidelines for MS management in 2013. Since then, new diagnostic criteria have been introduced, and multiple DMTs have been approved, including some indicated for progressive forms of MS — namely Ocrevus (ocrelizumab) for primary progressive MS (PPMS), together with Mayzent (siponimod) and Mavenclad (cladribine) for active secondary progressive MS (SPMS).
These recommendations aim to provide guidance to professionals treating MS patients, according to the MS Society of Canada, and span “starting, monitoring, and switching therapies to ensure that people are receiving the most optimum treatment.”
Guidelines favor an MS diagnosis using the 2017 McDonald criteria, which allows for an earlier and more accurate diagnosis than previously.
Before beginning treatment, the recommendations note the importance of appropriate screening, which may include evaluations of the immune system, liver function, pregnancy tests, and ensuring that vaccinations are up-to-date.
Treatment, the group advises, favor DMTs started soon after a person is diagnosed with relapsing MS (relapsing-remitting MS and active SPMS). Risk evaluation, based on clinical and demographic parameters, should be done on an ongoing basis to guide treatment decisions.
Beyond MS-specific DMTs, the recommendations also favor including wellness efforts, like encouraging a stop to smoking or regular exercise, in treatment plans. They stress that treatment plans also account for other health conditions.
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