Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management

O. Fernández; M. Delvecchio; G. Edan; S. Fredrikson; G. Giovannoni; H. P. Hartung; E. Havrdova; L. Kappos; C. Pozzilli; P. S. Soerensen; B. Tackenberg; P. Vermersch; G. Comi

doi:10.1111/ene.13581

Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management

O. Fernández^*, M. Delvecchio, G. Edan, S. Fredrikson, G. Giovannoni, H. P. Hartung, E. Havrdova, L. Kappos, C. Pozzilli, P. S. Soerensen, B. Tackenberg, P. Vermersch, G. Comi

^*Corresponding author for this work

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

Background and purpose: The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. Methods: A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Results: Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing−remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Conclusions: Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines.

Original language	English
Journal	European Journal of Neurology
Volume	25
Issue number	5
Pages (from-to)	739-746
Number of pages	8
ISSN	1351-5101
DOIs	https://doi.org/10.1111/ene.13581
Publication status	Published - 2018

Keywords

management
paediatric MS
primary progressive MS
secondary progressive MS

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10.1111/ene.13581

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Fernández, O., Delvecchio, M., Edan, G., Fredrikson, S., Giovannoni, G., Hartung, H. P., Havrdova, E., Kappos, L., Pozzilli, C., Soerensen, P. S., Tackenberg, B., Vermersch, P., & Comi, G. (2018). Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management. European Journal of Neurology, 25(5), 739-746. https://doi.org/10.1111/ene.13581

Fernández, O, Delvecchio, M, Edan, G, Fredrikson, S, Giovannoni, G, Hartung, HP, Havrdova, E, Kappos, L, Pozzilli, C, Soerensen, PS, Tackenberg, B, Vermersch, P & Comi, G 2018, 'Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management', European Journal of Neurology, vol. 25, no. 5, pp. 739-746. https://doi.org/10.1111/ene.13581

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title = "Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management",

abstract = "Background and purpose: The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. Methods: A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Results: Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing−remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Conclusions: Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines.",

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author = "O. Fern{\'a}ndez and M. Delvecchio and G. Edan and S. Fredrikson and G. Giovannoni and Hartung, {H. P.} and E. Havrdova and L. Kappos and C. Pozzilli and Soerensen, {P. S.} and B. Tackenberg and P. Vermersch and G. Comi",

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T2 - Progressive MS, paediatric MS, pregnancy and general management

AU - Fernández, O.

AU - Delvecchio, M.

AU - Edan, G.

AU - Fredrikson, S.

AU - Giovannoni, G.

AU - Hartung, H. P.

AU - Havrdova, E.

AU - Kappos, L.

AU - Pozzilli, C.

AU - Soerensen, P. S.

AU - Tackenberg, B.

AU - Vermersch, P.

AU - Comi, G.

PY - 2018

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N2 - Background and purpose: The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. Methods: A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Results: Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing−remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Conclusions: Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines.

AB - Background and purpose: The European Charcot Foundation supported the development of a set of surveys to understand current practice patterns for the diagnosis and management of multiple sclerosis (MS) in Europe. Part 2 of the report summarizes survey results related to secondary progressive MS (SPMS), primary progressive MS (PPMS), pregnancy, paediatric MS and overall patient management. Methods: A steering committee of MS neurologists developed case- and practice-based questions for two sequential surveys distributed to MS neurologists throughout Europe. Results: Respondents generally favoured changing rather than stopping disease-modifying treatment (DMT) in patients transitioning from relapsing−remitting MS to SPMS, particularly with active disease. Respondents would not initiate DMT in patients with typical PPMS symptoms, although the presence of ≥1 spinal cord or brain gadolinium-enhancing lesion might affect that decision. For patients considering pregnancy, respondents were equally divided on whether to stop treatment before or after conception. Respondents strongly favoured starting DMT in paediatric MS with active disease; recommended treatments included interferon, glatiramer acetate and, in John Cunningham virus negative patients, natalizumab. Additional results regarding practice-based questions and management are summarized. Conclusions: Results of part 2 of the survey of diagnostic and treatment practices for MS in Europe largely mirror results for part 1, with neurologists in general agreement about the treatment and management of SPMS, PPMS, pregnancy and paediatric MS as well as the general management of MS. However, there are also many areas of disagreement, indicating the need for evidence-based recommendations and/or guidelines.

KW - management

KW - paediatric MS

KW - primary progressive MS

KW - secondary progressive MS

U2 - 10.1111/ene.13581

DO - 10.1111/ene.13581

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SN - 1351-5101

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JO - European Journal of Neurology

JF - European Journal of Neurology

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ER -

Survey of diagnostic and treatment practices for multiple sclerosis (MS) in Europe. Part 2: Progressive MS, paediatric MS, pregnancy and general management

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