Clinical Course Of Multiple Sclerosis
The
clinical course of multiple sclerosis (MS) can follow different patterns, and this observation has led to the classification of distinct sorts of multiple sclerosis. The most common sort of
multiple sclerosis is termed
relapsing-remitting MS, during which progression involves symptoms of neurologic dysfunction frequently followed by partial or complete clinical recovery. Clinical course descriptions of MS are important for communication, design and recruitment of clinical trials, treatment
decision-making and style , recruitment of clinical trials and prognostication. Increased understanding of MS and its anatomy, including general concern that the first descriptors won't reflect more recently identified clinical aspects of the disease, prompted a re-examination of
multiple sclerosis disease phenotypes by the International Advisory Committee on Clinical Trials of multiple sclerosis. Clinically isolated
syndrome (CIS) wasn't included within the initial MS clinical descriptors. CIS is now recognized because the first clinical presentation of a disease that shows characteristics of inflammatory demyelination that would be MS, but has yet to fulfil criteria of dissemination in time. Natural
history studies and clinical trials of MS disease-modifying therapies have shown that CIS including
brain MRI lesions carries a high risk for meeting diagnostic criteria for MS. Clinical trials of MS disease-modifying agents show fewer treated individuals with CIS who develop a second exacerbation (the defining event for “clinically definite MS”) and reduced MRI activity. Regulatory acceptance of agents utilized in CIS to delay confirmed diagnosis of MS has further established CIS as a component of the MS
phenotype spectrum.
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