Patrick Vermersch1, Thomas Berger2, Ralf Gold3, Carsten Lukas4, Alex Rovira5, Bianca Meesen6, Declan Chard7, Manuel Comabella8, Jacqueline Palace9, Maria Trojano10. 1. University of Lille, CHRU de Lille, Lille International Research Inflammation Center (LIRIC), INSRRM U995, FHU Imminent, Lille, France patrick.vermersch@univ-lille2.fr. 2. Neuroimmunology and Multiple Sclerosis Clinic, Medical University of Innsbruck (MUI), Innsbruck, Austria. 3. Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany. 4. Department of Diagnostic and Interventional Radiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany. 5. Department of Radiology, Vall d'Hebron University Hospital, Barcelona, Spain. 6. Managing Director at Ismar Healthcare, Lier, Belgium. 7. NMR Research Unit, Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, University College London, London, UK/Biomedical Research Centre, University College London Hospitals (UCLH), National Institute for Health Research (NIHR), London, UK. 8. Department of Clinical Neuroimmunology, Multiple Sclerosis Center of Catalonia (Cemcat), Vall d'Hebron University Hospital, Barcelona, Spain. 9. Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK. 10. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
Abstract
BACKGROUND: Multiple sclerosis (MS) is a highly heterogeneous disease, both in its course and in its response to treatments. Effective biomarkers may help predict disability progression and monitor patients' treatment responses. OBJECTIVE: The aim of this review was to focus on how biomarkers may contribute to treatment individualisation in MS patients. METHODS: This review reflects the content of presentations, polling results and discussions on the clinical perspective of MS during the first and second Pan-European MS Multi-stakeholder Colloquia in Brussels in May 2014 and 2015. RESULTS: In clinical practice, magnetic resonance imaging (MRI) measures play a significant role in the diagnosis and follow-up of MS patients. Together with clinical markers, the rate of MRI-visible lesion accrual once a patient has started treatment may also help to predict subsequent treatment responsiveness. In addition, several molecular (immunological, genetic) biomarkers have been established that may play a role in predictive models of MS relapses and progression. To reach personalised treatment decisions, estimates of disability progression and likely treatment response should be carefully considered alongside the risk of serious adverse events, together with the patient's treatment expectations. CONCLUSION: Although biomarkers may be very useful for individualised decision making in MS, many are still research tools and need to be validated before implementation in clinical practice.
BACKGROUND:Multiple sclerosis (MS) is a highly heterogeneous disease, both in its course and in its response to treatments. Effective biomarkers may help predict disability progression and monitor patients' treatment responses. OBJECTIVE: The aim of this review was to focus on how biomarkers may contribute to treatment individualisation in MS patients. METHODS: This review reflects the content of presentations, polling results and discussions on the clinical perspective of MS during the first and second Pan-European MS Multi-stakeholder Colloquia in Brussels in May 2014 and 2015. RESULTS: In clinical practice, magnetic resonance imaging (MRI) measures play a significant role in the diagnosis and follow-up of MS patients. Together with clinical markers, the rate of MRI-visible lesion accrual once a patient has started treatment may also help to predict subsequent treatment responsiveness. In addition, several molecular (immunological, genetic) biomarkers have been established that may play a role in predictive models of MS relapses and progression. To reach personalised treatment decisions, estimates of disability progression and likely treatment response should be carefully considered alongside the risk of serious adverse events, together with the patient's treatment expectations. CONCLUSION: Although biomarkers may be very useful for individualised decision making in MS, many are still research tools and need to be validated before implementation in clinical practice.
Authors: Larry D Lynd; Natalie J Henrich; Celestin Hategeka; Carlo A Marra; Nicole Mittmann; Charity Evans; Anthony L Traboulsee Journal: Int J MS Care Date: 2018 Nov-Dec
Authors: Javier Ballesteros; Ester Moral; Luis Brieva; Elena Ruiz-Beato; Daniel Prefasi; Jorge Maurino Journal: Health Qual Life Outcomes Date: 2017-04-22 Impact factor: 3.186