Consensus recommendations for the diagnosis and treatment of multiple sclerosis: the Middle East North Africa Committee for Treatment and Research In Multiple Sclerosis (MENACTRIMS)

Abstract

With evolving diagnostic criteria and the advent of new oral and parenteral therapies for MS, most current diagnostic and treatment algorithms need re-evaluation and updating. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and in time, and exclude alternative diseases that can explain the findings at hand. The differential diagnostic workup should be guided by clinical and laboratory red flags to avoid unnecessary tests. Appropriate multiple sclerosis (MS) therapy selection is critical to maximize patient benefit. The current guidelines review the scientific evidence supporting treatment of acute relapses, radiologically isolated syndrome, clinically isolated syndrome, relapsing remitting MS, secondary progressive MS, and primary progressive MS. The purpose of these guidelines is to provide practical recommendations and algorithms for the diagnosis and treatment of MS based on current scientific evidence and clinical experience.

Keywords: :

• Consensus
• Guideline
• Multiple sclerosis
• Treatment

Transparency

Declaration of funding

This effort was sponsored and carried out under the supervision of MENACTRIMS (the Middle East and North Africa Committee for Treatment and Research In Multiple Sclerosis).

Author contributions: All authors participated as members of the panel of experts in the meeting that led to the development of the manuscript. All authors actively contributed to the discussion and the consensus reached. B.Y. and R.A. drafted the initial version of the manuscript and all authors discussed, reviewed and approved of the final version of the manuscript.

Declaration of financial/other relationships

The authors received no honoraria for this effort. There was no industry/pharmaceutical input or support or bias in the selection of the members or the recommendations reached. R.G. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article. B.Y., R.A., M.A.-J., M.D., J.I., S.H., I.A., M.S., S.Kh. Z.A. S.Ko., M.Z., J.A.K., T.A. and S.B. have disclosed that they have received honoraria from one or more of the following companies (individual disclosures available upon request): Biologix (Biogen Idec across the Middle East and North Africa region), Bayer, Novartis, Genzyme, Genpharm, Merck Serono and GSK. The manuscript represents the views and opinions of the members involved in the development of the guidelines.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.