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Related Experiment Videos

Identifying and treating patients with suboptimal responses.

B A Cohen1, O Khan, D R Jeffery

  • 1Davee Department of Neurology, Northwestern University, 710 North Lake Shore Drive, Abbott Hall 1121, Chicago, Illinois 60611, USA. bac106@northwestern.edu

Neurology
|December 30, 2004
PubMed
Summary
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Identifying suboptimal responders in multiple sclerosis (MS) is crucial for early treatment modification. Consensus criteria were developed to define suboptimal response and guide therapy for patients with worsening MS.

Area of Science:

  • Neurology
  • Immunology

Background:

  • Multiple sclerosis (MS) is an immune-mediated neurologic disease characterized by inflammatory events leading to disability.
  • Current therapies are most effective against early inflammatory relapses, highlighting the need for timely intervention.
  • Individual responses to disease-modifying agents (DMA) vary, necessitating identification of suboptimal responders.

Purpose of the Study:

  • To establish consensus criteria for defining suboptimal response to DMA in MS.
  • To facilitate early therapeutic modification for patients with worsening MS.
  • To prompt clinical studies for validating these criteria.

Main Methods:

  • A consensus meeting of neurologists from 16 MS centers in the United States was convened in January 2004.
  • Criteria for suboptimal response were developed based on relapse rates, recovery from attacks, lesion evolution, and functional decline.

Related Experiment Videos

  • Consideration was given to mitoxantrone use for patients with suboptimal response.

    • Main Results:

    • Consensus criteria for suboptimal MS response were defined.
    • Key indicators include relapse rates of 1/year or unchanged, incomplete recovery, polyregional involvement, new lesions, and functional loss impacting daily activities.
    • The panel discussed mitoxantrone as a treatment option for worsening MS.

    Conclusions:

    • Validated criteria are needed to identify suboptimal MS responders early.
    • Timely identification allows for therapeutic adjustments to prevent further neurologic decline.
    • These consensus criteria provide a framework for clinical practice and future research.