Biomarkers, aging among topics in new MS care guidelines
CMSC makes updated best practices available online
New diagnostic criteria and biomarkers, how to manage MS in older patients and children, and vaccine recommendations are among topics covered in a new set of guidelines for best practices in multiple sclerosis (MS) care.
The Consortium of Multiple Sclerosis Centers, a network of more than 15,000 clinicians and scientists dedicated to improving care for people with MS, made the guidelines available online. The document will also be distributed at the consortium’s annual meeting in late May.
“As MS care providers, how we communicate with patients about their treatment and prognosis affects how they view their outlook for the future,” Fred D. Lublin, MD, who chaired the panel that created the new guidelines, said in a CMSC press release. “Best Practices documents like this help MS care providers to get on the same page.”
Lublin is a neurology professor and director of the Corinne Goldsmith Dickinson Center for MS at the Icahn School of Medicine at Mount Sinai in New York.
MS is a chronic disorder characterized by inflammation in the brain and spinal cord, which damages the myelin sheath, a fatty covering around nerve fibers that helps nerves to send electrical signals. Damage to myelin and nerve cells leads to disruptions in nerve cell signaling, which ultimately causes MS symptoms.
Evolving landscape for MS care
The landscape for MS care continues to evolve as research advances. While there is no cure for MS, a range of therapies can help reduce disease activity and prevent future disability by reducing inflammation. Older therapies had more moderate efficacy, but a wide range of highly effective therapies is now available to patients.
The new guidelines cover the available treatment options, emphasizing that there is no one-size-fits-all approach. The choice of which treatment to use depends on each patient’s unique situation, taking into account factors like how the therapy is administered, medication safety profiles, the patient’s co-occurring health issues, and accessibility and cost constraints, according to the consortium.
“The goal is always to find a therapy that offers appropriate efficacy for the patient’s disease presentation and current level of inflammatory activity, optimal safety and tolerability, and administration method that the person can adhere to and feel comfortable with,” the guidelines state.
The guidelines include updates on best practices for how to diagnose MS and how to use biomarkers to track disease activity and response to treatment, as well as specific advice on caring for MS in children and older patients.
The guidelines emphasize that people with MS should receive all recommended vaccinations, noting that data do not suggest that vaccines increase MS disease activity. Still, vaccines containing live virus should be avoided in MS patients who have weakened immune systems due to anti-inflammatory treatment, the guidelines note.
“MS management changes on a regular basis,” Lublin said. “We currently have refined diagnostic criteria, evolving disease classification, additional disease-modifying therapies, and newer biomarkers to detect changes in disease progression and treatment effects.”
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