title: Treatment optimization in MS: Canadian MS Working Group updated recommendations.
abstract: The Canadian Multiple Sclerosis Working Group (CMSWG) developed practical recommendations in 2004 to assist clinicians in optimizing the use of disease-modifying therapies (DMT) in patients with relapsing multiple sclerosis. The CMSWG convened to review how disease activity is assessed, propose a more current approach for assessing suboptimal response, and to suggest a scheme for switching or escalating treatment. Practical criteria for relapses, Expanded Disability Status Scale (EDSS) progression and MRI were developed to classify the clinical level of concern as Low, Medium and High. The group concluded that a change in treatment may be considered in any RRMS patient if there is a high level of concern in any one domain (relapses, progression or MRI), a medium level of concern in any two domains, or a low level of concern in all three domains. These recommendations for assessing treatment response should assist clinicians in making more rational choices in their management of relapsing MS patients.
authors.affiliation: Ottawa Hospital Research Institute, University of Ottawa, Ottawa.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Freedman
authors.forename: Daniel
authors.initials: D
authors.lastname: Selchen
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Arnold
authors.forename: Alexandre
authors.initials: A
authors.lastname: Prat
authors.forename: Brenda
authors.initials: B
authors.lastname: Banwell
authors.forename: Michael
authors.initials: M
authors.lastname: Yeung
authors.forename: David
authors.initials: D
authors.lastname: Morgenthau
authors.forename: Yves
authors.initials: Y
authors.lastname: Lapierre
mesh_terms: D002170:Canada; D004185:Disability Evaluation; D019468:Disease Management; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000628:therapy*; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention
chemical_list: D007155:Immunologic Factors