BACKGROUND: Multiple sclerosis (MS) is a complex disease with new drugs becoming available in the past years. There is a need for a reference tool compiling current data to aid professionals in treatment decisions. OBJECTIVES: To develop an evidence-based clinical practice guideline for the pharmacological treatment of people with MS. METHODS: This guideline has been developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology and following the updated EAN recommendations. Clinical questions were formulated in Patients-Intervention-Comparator-Outcome (PICO) format and outcomes were prioritized. The quality of evidence was rated into four categories according to the risk of bias. The recommendations with assigned strength (strong and weak) were formulated based on the quality of evidence and the risk-benefit balance. Consensus between the panelists was reached by use of the modified nominal group technique. RESULTS: A total of 10 questions were agreed, encompassing treatment efficacy, response criteria, strategies to address suboptimal response and safety concerns and treatment strategies in MS and pregnancy. The guideline takes into account all disease-modifying drugs approved by the European Medicine Agency (EMA) at the time of publication. A total of 21 recommendations were agreed by the guideline working group after three rounds of consensus. CONCLUSION: The present guideline will enable homogeneity of treatment decisions across Europe.
- MeSH
- imunologické faktory aplikace a dávkování MeSH
- imunomodulace * MeSH
- konsensus * MeSH
- lidé MeSH
- medicína založená na důkazech normy MeSH
- roztroušená skleróza farmakoterapie MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Nové diagnostické kritériá pre sklerózu multiplex, ktoré integrujú magneticko-rezonančné zobrazovanie s klinickými a ostatnými paraklinickými metódami, sa zaviedli v roku 2001. „McDonaldove kritériá” sa všeobecne uznali a používali od roku 2001. Nové poznatky a konsenzus posilnili úlohu týchto kritérií v diagnostickom procese sklerózy multiplex, najmä pre rozpoznanie diseminácie lézií v čase, pre objasnenie významu diagnostiky spinálnych lézií a pre zjednodušenie diagnostiky primárne progresívneho ochorenia. Revízia McDonaldových diagnostických kritérií sklerózy multiplex v roku 2005 má zjednodušiť a urýchliť diagnózu SM pri zachovaní adekvátnej senzitivity a špecifity.
