Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis
ABSTRACT Background: Recent changes to the diagnostic criteria for multiple sclerosis (MS) and new medications have had a major impact on the way in which specialists manage the disease. Objective: To investigate factors considered by Brazilian neurologists in managing MS, and to identify how thes...
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| Language: | English |
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Thieme Revinter Publicações
2021-08-01
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000700598&tlng=en |
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| author | Cássia Elisa Marin Dagoberto Callegaro Marco Aurélio Lana-Peixoto Oscar Fernández Antonio Pereira Gomes Neto Claudia Cristina Ferreira Vasconcelos José Artur Costa d’Almeida Marcus Vinícius Magno Gonçalves Maria Fernanda Mendes Mônica Koncke Fiuza Parolin Osvaldo Nascimento Paulo Diniz da Gama Rafael Paternò Castello Dias-Carneiro Ronaldo Maciel Dias Alfredo Damasceno Jefferson Becker |
| author_facet | Cássia Elisa Marin Dagoberto Callegaro Marco Aurélio Lana-Peixoto Oscar Fernández Antonio Pereira Gomes Neto Claudia Cristina Ferreira Vasconcelos José Artur Costa d’Almeida Marcus Vinícius Magno Gonçalves Maria Fernanda Mendes Mônica Koncke Fiuza Parolin Osvaldo Nascimento Paulo Diniz da Gama Rafael Paternò Castello Dias-Carneiro Ronaldo Maciel Dias Alfredo Damasceno Jefferson Becker |
| author_sort | Cássia Elisa Marin |
| collection | DOAJ |
| description | ABSTRACT Background: Recent changes to the diagnostic criteria for multiple sclerosis (MS) and new medications have had a major impact on the way in which specialists manage the disease. Objective: To investigate factors considered by Brazilian neurologists in managing MS, and to identify how these contribute to diagnosis and treatment. Methods: Potential participants were selected by a steering committee (MS experts who developed this survey). Only MS specialists were included in the study (neurologists who had completed a neuroimmunology fellowship or who were treating more than 30 MS patients). Links to the online questionnaire were distributed between March 2019 and January 2020. This questionnaire was composed of sections with hypothetical MS scenarios. Results: Neurologists from 13 Brazilian states responded to the survey (n = 94). In the clinically isolated syndrome (CIS) scenario, the respondents agreed to treat patients with a high risk of MS diagnosis, whereas in the radiologically isolated syndrome (RIS) half of the respondents opted not to treat, even among high-risk patients. In cases of low-activity relapsing-remitting MS (RRMS), the choice of treatment was distributed among interferon beta, glatiramer acetate and teriflunomide, which were changed to fingolimod and natalizumab, as RRMS severity increased. The topics in which disagreement was found included practices regarding use of disease-modifying therapy (DMT) for pregnant patients and the washout period required for some DMTs. Conclusions: This study enabled identification of areas of agreement and disagreement about MS treatment among Brazilian neurologists, which can be used to update future protocols and improve patient management. |
| format | Article |
| id | doaj-art-7ff8f2e646e640bcb2fd3933ba70a56b |
| institution | Kabale University |
| issn | 1678-4227 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | Thieme Revinter Publicações |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj-art-7ff8f2e646e640bcb2fd3933ba70a56b2025-08-20T03:35:19ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272021-08-0179759860610.1590/0004-282x-anp-2020-0362Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosisCássia Elisa Marinhttps://orcid.org/0000-0003-2226-7286Dagoberto Callegarohttps://orcid.org/0000-0003-0077-173XMarco Aurélio Lana-Peixotohttps://orcid.org/0000-0003-2454-681XOscar Fernándezhttps://orcid.org/0000-0003-3696-789XAntonio Pereira Gomes Netohttps://orcid.org/0000-0002-0755-9478Claudia Cristina Ferreira Vasconceloshttps://orcid.org/0000-0003-0833-4024José Artur Costa d’Almeidahttps://orcid.org/0000-0002-6627-6515Marcus Vinícius Magno Gonçalveshttps://orcid.org/0000-0002-9127-7886Maria Fernanda Mendeshttps://orcid.org/0000-0003-3983-6019Mônica Koncke Fiuza Parolinhttps://orcid.org/0000-0003-2171-8241Osvaldo Nascimentohttps://orcid.org/0000-0003-3516-485XPaulo Diniz da Gamahttps://orcid.org/0000-0003-2585-1074Rafael Paternò Castello Dias-Carneirohttps://orcid.org/0000-0002-7649-0195Ronaldo Maciel Diashttps://orcid.org/0000-0003-3987-9596Alfredo Damascenohttps://orcid.org/0000-0002-7919-3989Jefferson Beckerhttps://orcid.org/0000-0002-9981-3620ABSTRACT Background: Recent changes to the diagnostic criteria for multiple sclerosis (MS) and new medications have had a major impact on the way in which specialists manage the disease. Objective: To investigate factors considered by Brazilian neurologists in managing MS, and to identify how these contribute to diagnosis and treatment. Methods: Potential participants were selected by a steering committee (MS experts who developed this survey). Only MS specialists were included in the study (neurologists who had completed a neuroimmunology fellowship or who were treating more than 30 MS patients). Links to the online questionnaire were distributed between March 2019 and January 2020. This questionnaire was composed of sections with hypothetical MS scenarios. Results: Neurologists from 13 Brazilian states responded to the survey (n = 94). In the clinically isolated syndrome (CIS) scenario, the respondents agreed to treat patients with a high risk of MS diagnosis, whereas in the radiologically isolated syndrome (RIS) half of the respondents opted not to treat, even among high-risk patients. In cases of low-activity relapsing-remitting MS (RRMS), the choice of treatment was distributed among interferon beta, glatiramer acetate and teriflunomide, which were changed to fingolimod and natalizumab, as RRMS severity increased. The topics in which disagreement was found included practices regarding use of disease-modifying therapy (DMT) for pregnant patients and the washout period required for some DMTs. Conclusions: This study enabled identification of areas of agreement and disagreement about MS treatment among Brazilian neurologists, which can be used to update future protocols and improve patient management.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000700598&tlng=enMultiple SclerosisNeurologistsDiagnosisClinical Decision-MakingImmunotherapy |
| spellingShingle | Cássia Elisa Marin Dagoberto Callegaro Marco Aurélio Lana-Peixoto Oscar Fernández Antonio Pereira Gomes Neto Claudia Cristina Ferreira Vasconcelos José Artur Costa d’Almeida Marcus Vinícius Magno Gonçalves Maria Fernanda Mendes Mônica Koncke Fiuza Parolin Osvaldo Nascimento Paulo Diniz da Gama Rafael Paternò Castello Dias-Carneiro Ronaldo Maciel Dias Alfredo Damasceno Jefferson Becker Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis Arquivos de Neuro-Psiquiatria Multiple Sclerosis Neurologists Diagnosis Clinical Decision-Making Immunotherapy |
| title | Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis |
| title_full | Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis |
| title_fullStr | Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis |
| title_full_unstemmed | Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis |
| title_short | Evaluation of diagnosis and treatment practices of Brazilian neurologists among patients with multiple sclerosis |
| title_sort | evaluation of diagnosis and treatment practices of brazilian neurologists among patients with multiple sclerosis |
| topic | Multiple Sclerosis Neurologists Diagnosis Clinical Decision-Making Immunotherapy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000700598&tlng=en |
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