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Treating to target in multiple sclerosis: Do we know how to measure whether we hit it?
Gabriel Bsteh1,2, Nik Krajnc1,2, Patrick Altmann1,2
1Department of Neurology, Medical University of Vienna, Vienna, Austria.
European Journal of Neurology
|October 24, 2024
Summary
This study reviews multiple sclerosis treatments, advocating for a treat-to-target approach to suppress disease activity. It proposes measurable outcomes and identifies gaps for optimizing early intervention strategies.
Area of Science:
- Neuroimmunology
- Clinical Neurology
- Evidence-Based Medicine
Background:
- Multiple sclerosis (MS) treatment has shifted towards a treat-to-target strategy.
- The goal is to suppress MS disease activity early and below detectable levels.
- Reappraising outcome measures is crucial for enabling this approach.
Purpose of the Study:
- To systematically review outcome measures for multiple sclerosis treat-to-target strategies.
- To assess the evidence, utility, and implementability of these measures in clinical practice.
Main Methods:
- A comprehensive systematic literature review of over 1000 studies was performed.
- The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 methodology was utilized.
- Focus was placed on evidence, clinical utility, and practical implementation.
Main Results:
- A set of measurable outcomes for routine clinical practice was proposed.
- Advanced and aspirational outcome measures requiring additional resources were identified.
- Knowledge and technology gaps hindering the treat-to-target approach were outlined.
Conclusions:
- This review provides a foundation for defining evidence-based outcome targets in multiple sclerosis.
- It serves relevant stakeholders and regulatory authorities in advancing treat-to-target strategies.
- The findings aim to optimize early disease activity suppression in MS management.
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