Neurology

Putting shared decision-making into practice

 

Three elements
Decision aids
Use of patient-reported outcome measures (PROMs)
Switching therapy
SDM: strengths and limitations

The concept of shared decision-making (SDM) has gained momentum in recent years as the preferred approach to MS care. The emergence of SDM two decades ago can be traced back to an acknowledgement of the greater role patients wanted to play in their care decisions, in part due to the recognition that patients’ treatment goals may differ from those of the clinician (Kumar et al. Patient Prefer Adherence 2021;15:1515-1527); and a proliferation of treatments that were similar so that medication choices were preference-sensitive. The advent of social media provided a further spur to patients’ notions of empowerment and participatory medicine (Kantor et al. Neurol Ther 2018;7:37-49). Read More

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The end of MS phenotypes?

 

The International Advisory Committee on Clinical Trials in Multiple Sclerosis is recommending that the clinical course descriptions of MS – relapsing-remitting (RRMS), secondary-progressive (SPMS) and primary-progressive (PPMS) – be discarded in favour of a more biology-based approach (Kuhlmann et al. Lancet Neurol 2022; epublished November 18, 2022). Read More

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MS Awards 2022 – Oddities and Observations

 

MS Prodromedary Prize
A study in Saudi Arabia found that the most important risk factor for the development of MS was consumption of camel milk (odds ratio 2.50) (Alkhawajah et al. Neuroepidemiology 2022;56:97-103). Read More

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Effectiveness of COVID boosters in MS: an update

 

Two recent studies have reported that COVID boosters can increase the humoral response in MS patients during treatment with ocrelizumab or fingolimod. A number of studies have reported that these disease-modifying therapies (DMT) are associated with a blunted humoral response to COVID vaccination (Achiron et al. Ther Adv Neurol Disord 2021;14:17562864211012835. Gallo et al. Neurol Sci 2021;42:3523-3526). Read More