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Multiple Sclerosis Disease-Modifying Treatment Algorithms: 2025 Positioning of the Portuguese Multiple Sclerosis

Carlos Capela1, Ernestina Santos2, Filipe Palavra3

  • 1Grupo de Estudos de Esclerose Múltipla (GEEM). Sociedade Portuguesa de Neurologia. Matosinhos. Portugal; Multiple Sclerosis Centre of Integrated Responsibility. Hospital Santo António dos Capuchos. Unidade Local de Saúde de São José. Lisbon. Portugal; Centro Clínico Académico de Lisboa. NOVA Medical School. Universidade NOVA de Lisboa. Lisbon. Portugal.

Acta Medica Portuguesa
|May 6, 2025
PubMed
Summary

Portuguese experts propose updated multiple sclerosis (MS) treatment guidelines. This aims to incorporate new therapies and improve patient outcomes by addressing gaps in current national strategies for various MS subtypes.

Keywords:
Age of OnsetMultiple SclerosisMultiple Sclerosis/drug therapyRelapsing-Remitting/drug therapy

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Area of Science:

  • Neuroimmunology and Neurodegenerative Diseases
  • Clinical Neurology and Therapeutics

Background:

  • Multiple sclerosis (MS) is a chronic, autoimmune neurodegenerative disease affecting the central nervous system, with a prevalence of 64.4 per 100,000 in Portugal.
  • Current MS treatment options, particularly for progressive forms, are limited, and national management strategies require updating to reflect recent advancements in disease-modifying therapies (DMTs).

Purpose of the Study:

  • To identify and address gaps in existing Portuguese MS treatment algorithms.
  • To propose evidence-based enhancements aligned with global standards for optimizing MS management in Portugal.
  • To improve treatment selection and patient outcomes within the Portuguese healthcare system.

Main Methods:

  • Development of updated recommendations by nine Portuguese neurology experts from the Portuguese Multiple Sclerosis Study Group.
  • Inclusion of DMT algorithms for diverse MS subtypes, including isolated syndromes, relapsing-remitting MS (RRMS), and progressive MS.
  • Consideration of specific patient populations such as pediatric-onset MS, late-onset MS, and MS during pregnancy/breastfeeding.

Main Results:

  • Provides evidence- and clinical practice-based recommendations for optimizing MS management decisions.
  • Offers tailored DMT algorithms for various MS subtypes and clinical scenarios.
  • Highlights the need for urgent revision of national MS treatment frameworks.

Conclusions:

  • The proposed enhancements aim to align Portuguese MS care with international guidelines and recent scientific evidence.
  • Updating national frameworks is crucial to reduce the socio-economic burden and improve long-term health outcomes for MS patients in Portugal.
  • These recommendations will aid healthcare professionals in making informed treatment choices for individuals with multiple sclerosis.