Personalized therapy in multiple sclerosis: an Italian Delphi consensus

Area of Science:

• Neurology
• Immunology
• Pharmacology

Background:

• The availability of disease-modifying therapies (DMTs) for multiple sclerosis (MS) enables personalized treatment strategies.
• Italian efforts focus on interdisciplinary, patient-centered care and equitable access to optimized MS therapies.
• Ensuring homogeneous and personalized therapeutic strategies remains a key challenge in MS management.

Purpose of the Study:

• To evaluate consensus among Italian neurologists regarding personalized multiple sclerosis (MS) treatment.
• To identify key factors in patient decision-making, treatment adherence, and quality of life in MS care.
• To assess perceptions of treatment efficacy, safety, and sequencing for high-efficacy DMTs.

Main Methods:

• Delphi methodology employed with a panel of Italian neurologists specializing in MS.
• Evaluation of consensus on personalized therapy, patient involvement, treatment flexibility, self-management, efficacy, safety, and sequencing.
• Analysis of 166 votes to determine areas of consensus and non-consensus in MS treatment.

Main Results:

• Consensus was reached on 70% of statements, highlighting the central role of neurologists and patient involvement in MS therapy.
• Personalized therapy, patient inclusion in choices, and managing quality of life and caregiver burden are emphasized.
• High-efficacy DMTs (e.g., cladribine, anti-CD20 therapies) received positive consensus for efficacy and administration convenience.

Conclusions:

• Research provides best practices for optimizing multiple sclerosis (MS) patient outcomes.
• Tailored and well-communicated therapeutic strategies are essential for improving MS care.
• The findings offer a roadmap for enhancing personalized treatment approaches in MS.