title: The clinical perspective: How to personalise treatment in MS and how may biomarkers including imaging contribute to this?
abstract: Multiple sclerosis (MS) is a highly heterogeneous disease, both in its course and in its response to treatments. Effective biomarkers may help predict disability progression and monitor patients' treatment responses.
  
  
  
  The aim of this review was to focus on how biomarkers may contribute to treatment individualisation in MS patients.
  
  
  
  This review reflects the content of presentations, polling results and discussions on the clinical perspective of MS during the first and second Pan-European MS Multi-stakeholder Colloquia in Brussels in May 2014 and 2015.
  
  
  
  In clinical practice, magnetic resonance imaging (MRI) measures play a significant role in the diagnosis and follow-up of MS patients. Together with clinical markers, the rate of MRI-visible lesion accrual once a patient has started treatment may also help to predict subsequent treatment responsiveness. In addition, several molecular (immunological, genetic) biomarkers have been established that may play a role in predictive models of MS relapses and progression. To reach personalised treatment decisions, estimates of disability progression and likely treatment response should be carefully considered alongside the risk of serious adverse events, together with the patient's treatment expectations.
  
  
  
  Although biomarkers may be very useful for individualised decision making in MS, many are still research tools and need to be validated before implementation in clinical practice.
authors.affiliation: University of Lille, CHRU de Lille, Lille International Research Inflammation Center (LIRIC), INSRRM U995, FHU Imminent, Lille, France patrick.vermersch@univ-lille2.fr.
authors.forename: Patrick
authors.initials: P
authors.lastname: Vermersch
authors.affiliation: Neuroimmunology and Multiple Sclerosis Clinic, Medical University of Innsbruck (MUI), Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Berger
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.affiliation: Department of Diagnostic and Interventional Radiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Lukas
authors.affiliation: Department of Radiology, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Rovira
authors.affiliation: Managing Director at Ismar Healthcare, Lier, Belgium.
authors.forename: Bianca
authors.initials: B
authors.lastname: Meesen
authors.affiliation: NMR Research Unit, Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, University College London, London, UK/Biomedical Research Centre, University College London Hospitals (UCLH), National Institute for Health Research (NIHR), London, UK.
authors.forename: Declan
authors.initials: D
authors.lastname: Chard
authors.affiliation: Department of Clinical Neuroimmunology, Multiple Sclerosis Center of Catalonia (Cemcat), Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Comabella
authors.affiliation: Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Palace
authors.affiliation: Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Trojano
mesh_terms: D015415:Biomarkers / Q000032:analysis; D003299:Cooperative Behavior; D006801:Humans; D033183:Interdisciplinary Communication; D008279:Magnetic Resonance Imaging; D057054:Molecular Imaging / Q000379:methods*; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D057285:Precision Medicine; D011237:Predictive Value of Tests; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D000073597:Stakeholder Participation
chemical_list: D015415:Biomarkers
keywords: Biological markers; disease progression; drug-related side effects and adverse reactions; magnetic resonance imaging; multiple sclerosis; treatment response