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Unraveling treatment response in multiple sclerosis: A clinical and MRI challenge

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  1. Author response: Nationwide prevalence and incidence study of neuromyelitis optica spectrum disorder in Denmark

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  2. Fat oxidation is impaired during exercise in lipin-1 deficiency

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  3. Declining malformation rates with changed antiepileptic drug prescribing: An observational study

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  4. Neuromuscular adverse events associated with anti-PD-1 monoclonal antibodies: Systematic review

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  5. Clinical spectrum of STX1B-related epileptic disorders

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  1. Facing privacy in neuroimaging: removing facial features degrades performance of image analysis methods

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  2. Author response: Nationwide prevalence and incidence study of neuromyelitis optica spectrum disorder in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. A free and simple computerized screening test for visual field defects

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  4. Comparative effectiveness of teriflunomide and dimethyl fumarate: A nationwide cohort study

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  • and the MAGNIMS Study Group
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Over the last few decades, the improved diagnostic criteria, the wide use of MRI, and the growing availability of effective pharmacologic treatments have led to substantial advances in the management of multiple sclerosis (MS). The importance of early diagnosis and treatment is now well-established, but there is still no consensus on how to define and monitor response to MS treatments. In particular, the clinical relevance of the detection of minimal MRI activity is controversial and recommendations on how to define and monitor treatment response are warranted. An expert panel of the Magnetic Resonance Imaging in MS Study Group analyzed and discussed published studies on treatment response in MS. The evolving concept of no evidence of disease activity and its effect on predicting long-term prognosis was examined, including the option of defining a more realistic target for daily clinical practice: minimal evidence of disease activity. Advantages and disadvantages associated with the use of MRI activity alone and quantitative scoring systems combining on-treatment clinical relapses and MRI active lesions to detect treatment response in the real-world setting were also discussed. While most published studies on this topic involved patients treated with interferon-β, special attention was given to more recent studies providing evidence based on treatment with other and more efficacious oral and injectable drugs. Finally, the panel identified future directions to pursue in this research field.

Original languageEnglish
JournalNeurology
Volume92
Issue number4
Pages (from-to)180-192
Number of pages13
ISSN0028-3878
DOIs
Publication statusPublished - 2019

ID: 56665487