AUTHOR=Meca-Lallana José E. , Casanova Bonaventura , Rodríguez-Antigüedad Alfredo , Eichau Sara , Izquierdo Guillermo , Durán Carmen , Río Jordi , Hernández Miguel Ángel , Calles Carmen , Prieto-González José M. , Ara José Ramón , Uría Dionisio F. , Costa-Frossard Lucienne , García-Merino Antonio , Oreja-Guevara Celia TITLE=Consensus on early detection of disease progression in patients with multiple sclerosis JOURNAL=Frontiers in Neurology VOLUME=13 YEAR=2022 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.931014 DOI=10.3389/fneur.2022.931014 ISSN=1664-2295 ABSTRACT=Background

Early identification of the transition from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS) can be challenging for clinicians, as diagnostic criteria for SPMS are primarily based on physical disability and a holistic interpretation.

Objective

To establish a consensus on patient monitoring to identify promptly disease progression and the most useful clinical and paraclinical variables for early identification of disease progression in MS.

Methods

A RAND/UCLA Appropriateness Method was used to establish the level of agreement among a panel of 15 medical experts in MS. Eighty-three items were circulated to the experts for confidential rating of the grade of agreement and recommendation. Consensus was defined when ≥66% agreement or disagreement was achieved.

Results

Consensus was reached in 72 out of 83 items (86.7%). The items addressed frequency of follow-up visits, definition of progression, identification of clinical, cognitive, and radiological assessments as variables of suspected or confirmed SPMS diagnosis, the need for more accurate assessment tools, and the use of promising molecular and imaging biomarkers to predict disease progression and/or diagnose SPMS.

Conclusion

Consensus achieved on these topics could guide neurologists to identify earlier disease progression and to plan targeted clinical and therapeutic interventions during the earliest stages of SPMS.