Edgardo Cristiano1, Juan Ignacio Rojas2, Patricio Abad3, Tarso Adoni4, Jorge Barahona5, Jefferson Becker6, Adriana Carrá7, José Flores8, Manuel Fruns9, Nora Fernández Liguori10, Orlando Garcea11, Juan García Bónito12, Diego Giunta13, Fernando Gracia14, Fernando Hamuy15, Miguel A Macias Islas16, Cárlos Navas17, Liliana Ordoñez Boschetti18, Liliana Patrucco2, Douglas K Sato6, Jorge Correale19. 1. Centro de esclerosis múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina. Electronic address: edgardo.cristiano@hospitalitaliano.org.ar. 2. Centro de esclerosis múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina. 3. Servicio Neurologia, Hospital Metropolitano de Quito, Ecuador. 4. Multiple Sclerosis Center, Hospital Sírio-Libanês, São Paulo, Brazil. 5. Centro Esclerosis Múltiple, Clínica Alemana de Santiago de Chile, Chile. 6. Brain Institute of Rio Grande do Sul, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil. 7. MS Section Hospital Britanico Buenos Aires, Argentina; Neurociencias Fundación Favaloro/INECO, Buenos Aires, Argentina. 8. Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, Mexico; Centro Neurológico ABC Santa Fé, Ciudad de México, Mexico. 9. Clinica Las Condes, Santiago de Chile, Chile. 10. Hospital Enrique Tornu, Buenos Aires, Argentina; Sanatorio Guemes, Buenos Aires, Argentina. 11. Clínica de Esclerosis Múltiple, Hospital Ramos Mejía, Buenos Aires, Argentina. 12. Clinica de Marly Bogota, Sistema Nacional De Salud Colombiano, Colombia. 13. Clinical Research Section, Hospital Italiano de Buenos Aires, Argentina. 14. Clinica de Esclerosis Multiple, Servicio de Neurologia Hospital Santo Tomas, Universidad Interamericana de Panama, Panama. 15. Departamento de Neurologia, Hospital IMT, Paraguay; Departamento de Neurologia de Diagnóstico Codas Thompson, Paraguay. 16. Departamento de Neurociencia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Mexico. 17. Clinica Enfermedad Desmielinizante Clinica Universitaria Colombia, Colombia. 18. Hospital Español de Mexico, Mexico. 19. Department of Neurology, Institute for Neurological Research Dr Raul Carrea, FLENI, Argentina.
Abstract
Despite the availability of a large amount of information regarding the management and care of relapsing remitting multiple sclerosis (RRMS) patients, there is scant information about recommendations on how to care for primary progressive MS (PPMS) patients. The objective of this study was to review how PPMS patients should be assessed and cared for in Latin America (LATAM). METHODS: A panel of neurology experts from LATAM dedicated to the diagnosis and care of MS patients gathered virtually during 2017 and 2018 to carry out a consensus recommendation on the diagnosis and treatment of PPMS patients in LATAM. To achieve consensus, the methodology of "formal consensus-RAND/UCLA method" was used. RESULTS: Recommendations focused on disease management, and specific and symptomatic disease treatment were determined. The main consensus was that the 2017 McDonald criteria should be used for diagnosis but that the exclusion of regional diseases is strongly recommended; that specific considerations should be taken regarding immunotherapy treatments used in MS due to the scarce evidence available; and that a general approach that considers symptomatic treatment and rehabilitation should be performed in affected patients to improve their status. CONCLUSIONS: The recommendations of these consensus guidelines attempt to optimize the health care and management of PPMS patients in LATAM.
Despite the availability of a large amount of information regarding the management and care of relapsing remitting multiple sclerosis (RRMS) patients, there is scant information about recommendations on how to care for primary progressive MS (PPMS) patients. The objective of this study was to review how PPMS patients should be assessed and cared for in Latin America (LATAM). METHODS: A panel of neurology experts from LATAM dedicated to the diagnosis and care of MS patients gathered virtually during 2017 and 2018 to carry out a consensus recommendation on the diagnosis and treatment of PPMS patients in LATAM. To achieve consensus, the methodology of "formal consensus-RAND/UCLA method" was used. RESULTS: Recommendations focused on disease management, and specific and symptomatic disease treatment were determined. The main consensus was that the 2017 McDonald criteria should be used for diagnosis but that the exclusion of regional diseases is strongly recommended; that specific considerations should be taken regarding immunotherapy treatments used in MS due to the scarce evidence available; and that a general approach that considers symptomatic treatment and rehabilitation should be performed in affected patients to improve their status. CONCLUSIONS: The recommendations of these consensus guidelines attempt to optimize the health care and management of PPMS patients in LATAM.
Authors: José E Meca-Lallana; Bonaventura Casanova; Alfredo Rodríguez-Antigüedad; Sara Eichau; Guillermo Izquierdo; Carmen Durán; Jordi Río; Miguel Ángel Hernández; Carmen Calles; José M Prieto-González; José Ramón Ara; Dionisio F Uría; Lucienne Costa-Frossard; Antonio García-Merino; Celia Oreja-Guevara Journal: Front Neurol Date: 2022-07-28 Impact factor: 4.086