Defining the clinical course of multiple sclerosis: the 2013 revisions.

Abstract

Accurate clinical course descriptions (phenotypes) of multiple sclerosis (MS) are important for communication, prognostication, design and recruitment of clinical trials, and treatment decision-making. Standardized descriptions published in 1996 based on a survey of international MS experts provided purely clinical phenotypes based on data and consensus at that time, but imaging and biological correlates were lacking. Increased understanding of MS and its pathology, coupled with general concern that the original descriptors may not adequately reflect more recently identified clinical aspects of the disease, prompted a re-examination of MS disease phenotypes by the International Advisory Committee on Clinical Trials of MS. While imaging and biological markers that might provide objective criteria for separating clinical phenotypes are lacking, we propose refined descriptors that include consideration of disease activity (based on clinical relapse rate and imaging findings) and disease progression. Strategies for future research to better define phenotypes are also outlined.

• Authors: Fred D Lublin, Stephen C Reingold, Jeffrey A Cohen, Gary R Cutter, Per Soelberg Sørensen, Alan J Thompson, Jerry S Wolinsky, Laura J Balcer, Brenda Banwell, Frederik Barkhof, Bruce Bebo Jr, Peter A Calabresi, Michel Clanet, Giancarlo Comi, Robert J Fox, Mark S Freedman, Andrew D Goodman, Matilde Inglese, Ludwig Kappos, Bernd C Kieseier, John A Lincoln, Catherine Lubetzki, Aaron E Miller, Xavier Montalban, Paul W O'Connor, John Petkau, Carlo Pozzilli, Richard A Rudick, Maria Pia Sormani, Olaf Stüve, Emmanuelle Waubant, Chris H Polman
• Journal: Neurology (Neurology) Vol. 83 Issue 3 Pg. 278-86 (Jul 15 2014) ISSN: 1526-632X [Electronic] United States
• PMID: 24871874 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 American Academy of Neurology.

Topics

• Clinical Trials as Topic (standards)
• Consensus
• Humans
• Multiple Sclerosis (classification, physiopathology, therapy)
• Societies, Medical (standards)