title: Management of relapsing-remitting multiple sclerosis in Latin America: practical recommendations for treatment optimization.
abstract: The Latin American MS Experts' Forum has developed practical recommendations on the initiation and optimization of disease-modifying therapies in patients with relapsing-remitting multiple sclerosis (RRMS). The recommendations reflect the unique epidemiology of MS and the clinical practice environment in Latin American countries. Treatment response may be evaluated according to changes in relapses; progression, as assessed by the Expanded Disability Status Scale and the Timed 25-foot Walk; and lesion number on magnetic resonance imaging. Follow-up assessments are recommended every six months, or annually for stable patients. Cognitive function should be evaluated in all RRMS patients at baseline and annually thereafter. These recommendations are intended to assist clinicians in Latin America in developing a rational approach to treatment selection and sequencing for their RRMS patients.
authors.affiliation: Institute for Neurological Research Dr. Raúl Carrea FLENI, Buenos Aires, Argentina. Electronic address: jcorreale@fleni.org.ar.
authors.forename: Jorge
authors.initials: J
authors.lastname: Correale
authors.affiliation: Hospital Metropolitano, Quito, Ecuador.
authors.forename: Patricio
authors.initials: P
authors.lastname: Abad
authors.affiliation: MS Hospital Da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Regina
authors.initials: R
authors.lastname: Alvarenga
authors.affiliation: Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Brazil.
authors.forename: Soniza
authors.initials: S
authors.lastname: Alves-Leon
authors.affiliation: Cátedra de Neurología, Hospital Universitario de Caracas, Venezuela.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Armas
authors.affiliation: Clínica Alemana, Santiago, Chile.
authors.forename: Jorge
authors.initials: J
authors.lastname: Barahona
authors.affiliation: Instituto de Neurologia, Facultad de Medicina, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Buzó
authors.affiliation: Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, México City, Mexico.
authors.forename: Teresa
authors.initials: T
authors.lastname: Corona
authors.affiliation: Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Cristiano
authors.affiliation: Facultad de Ciencias de la Salud-ULACIT, Panamá, Panama.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gracia
authors.affiliation: Servicio de Neurología, Clinica de Marly, and Entidad Prestadora De Servicios de Salud Nogales, Bogota, Colombia.
authors.forename: Juan García
authors.initials: JG
authors.lastname: Bonitto
authors.affiliation: Departamento de Neurociencias CUCS UdeG, Mexico.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Macías
authors.affiliation: Centro Medico Docente La Trinidad, Caracas, Venezuela.
authors.forename: Arnoldo
authors.initials: A
authors.lastname: Soto
authors.affiliation: Universidad Peruana Cayetano Heredia, Hypnos Instituto del Sueño, Clinica San Felipe, Lima, Peru.
authors.forename: Darwin
authors.initials: D
authors.lastname: Vizcarra
authors.affiliation: Ottawa Hospital Research Institute, University of Ottawa, Multiple Sclerosis Research Unit, Ottawa, Canada.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Freedman
mesh_terms: D019468:Disease Management; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016899:Interferon-beta / Q000627:therapeutic use; D007843:Latin America / Q000453:epidemiology; D008942:Mitoxantrone / Q000627:therapeutic use; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D017410:Practice Guidelines as Topic / Q000592:standards*; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D014807:Vitamin D; D016899:Interferon-beta; D008942:Mitoxantrone
keywords: Algorithm; Clinical recommendations; Disability; Latin America; MRI; Multiple sclerosis; Relapses; Treatment