Saturday, 24 September 2016

ClinicSpeak & NeuroSpeak: MS Ireland & Brain Health

Brain Health and wellness in MS is all the rage. Good! #BrainHealth #MSBlog #ClinicSpeak

"I am in Cork at MS Ireland's annual meeting. The good news is that this year's meeting for HCPs and MSers is focusing on Brain Health and Wellness. It is very reassuring how quickly awareness on the Brain Health issue had spread across the field. I sincerely hope the 'Brain Health' policy document has something to do with it (please see our new website). The good news is that the policy document has now been published in full and can be cited via PubMed (see below). If you haven't read it yet give it a go; it is written in plain English for a wide audience."





Giovannoni et al. Brain health: time matters in multiple sclerosis. Mult Scler Relat Disord. 2016 Sep;9 Suppl 1:S5-S48. 

INTRODUCTION: We present international consensus recommendations for improving diagnosis, management and treatment access in multiple sclerosis (MS). Our vision is that these will be used widely among those committed to creating a better future for people with MS and their families.


METHODS: Structured discussions and literature searches conducted in 2015 examined the personal and economic impact of MS, current practice in diagnosis, treatment and management, definitions of disease activity and barriers to accessing disease-modifying therapies (DMTs).

RESULTS: Delays often occur before a person with symptoms suggestive of MS sees a neurologist. Campaigns to raise awareness of MS are needed, as are initiatives to improve access to MS healthcare professionals and services. We recommend a clear treatment goal: to maximize neurological reserve, cognitive function and physical function by reducing disease activity. Treatment should start early, with DMT and lifestyle measures. All parameters that predict relapses and disability progression should be included in the definition of disease activity and monitored regularly when practical. On suboptimal control of disease activity, switching to a DMT with a different mechanism of action should be considered. A shared decision-making process that embodies dialogue and considers all appropriate DMTs should be implemented. Monitoring data should be recorded formally in registries to generate real-world evidence. In many jurisdictions, access to DMTs is limited. To improve treatment access the relevant bodies should consider all costs to all parties when conducting economic evaluations and encourage the continuing investigation, development and use of cost-effective therapeutic strategies and alternative financing models.

CONCLUSIONS: The consensus findings of an international author group recommend a therapeutic strategy based on proactive monitoring and shared decision-making in MS. Early diagnosis and improved treatment access are also key components.

1 comment:

  1. The question that needs to be answered is this: do interventions that seemingly slow down brain atrophy (eg Simvastatins, Alpha Lipoic Acid) translate into reduced progressive disability or cognitive impairment?

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