In November 2022 Lancet Neurology published an article by some experts in MS research entitled "Multiple sclerosis progression: Time for a new mechanism-driven framework." It is discussed here:
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And there was a Webinar featuring three of the authors,* which I watched today. I was curious about just what new classification would be proposed--if any.
As it turns out, no new classification was proposed. Some lists were made, and they agreed that the old classification scheme doesn't work well any more (if it ever did). What they seemed to be aiming toward is a framework that will enable neurologists to determine what MS drugs will work on which types of patients.
The Webinar wasn't easy to watch as one of the speakers was difficult to understand, there were no captions, and there were slides with printed material that were difficult to read. However, this is the current classification scheme as they presented it--the scheme that they would like to replace with something "mechanism-driven."
The chart showed MS divided into 2 main categories: Relapsing MS and Progressive Disease.
Under "Relapsing MS" there are 2 subcategories:
--CIS (for Clinically Isolated syndrome),
which is subdivided into Nonactive and Active.
--RRMS
which is also subdivided into Nonactive and Active
Under "Progressive Disease" there are 2 subcategories--PPMS and SPMS. These break down into 4 sub-subcategories:
--Active with progression
--Active without progression
--Nonactive with progression
--Nonactive without progression
So this matter is still in the planning-and-discussion stage, and they are proceeding with caution because this change will affect how the MS drugs are prescribed as well as many other aspects of MS.
It's notable that the classification process being discussed doesn't involve symptoms at all. And by "active" the FDA means "having relapses" only, while the EMA (European Medicines Agency) defines "active" as "having relapses or imaging features consistent with inflammation."
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* The authors include Alan J. Thompson, MD--and this is from Wikipedia:
Only registered and activated users can see links., Click Here To Register...
And there was a Webinar featuring three of the authors,* which I watched today. I was curious about just what new classification would be proposed--if any.
As it turns out, no new classification was proposed. Some lists were made, and they agreed that the old classification scheme doesn't work well any more (if it ever did). What they seemed to be aiming toward is a framework that will enable neurologists to determine what MS drugs will work on which types of patients.
The Webinar wasn't easy to watch as one of the speakers was difficult to understand, there were no captions, and there were slides with printed material that were difficult to read. However, this is the current classification scheme as they presented it--the scheme that they would like to replace with something "mechanism-driven."
The chart showed MS divided into 2 main categories: Relapsing MS and Progressive Disease.
Under "Relapsing MS" there are 2 subcategories:
--CIS (for Clinically Isolated syndrome),
which is subdivided into Nonactive and Active.
--RRMS
which is also subdivided into Nonactive and Active
Under "Progressive Disease" there are 2 subcategories--PPMS and SPMS. These break down into 4 sub-subcategories:
--Active with progression
--Active without progression
--Nonactive with progression
--Nonactive without progression
So this matter is still in the planning-and-discussion stage, and they are proceeding with caution because this change will affect how the MS drugs are prescribed as well as many other aspects of MS.
It's notable that the classification process being discussed doesn't involve symptoms at all. And by "active" the FDA means "having relapses" only, while the EMA (European Medicines Agency) defines "active" as "having relapses or imaging features consistent with inflammation."
-------
* The authors include Alan J. Thompson, MD--and this is from Wikipedia:
Alan J. Thompson, MD, FMedSci, FRCP, FRCPI, is Dean of the Faculty of Brain Sciences at Only registered and activated users can see links., Click Here To Register...; Pro-Provost for London at Only registered and activated users can see links., Click Here To Register...; Garfield Weston Professor of Clinical Neurology and Neurorehabilitation at the Only registered and activated users can see links., Click Here To Register.... He is also a consultant neurologistOnly registered and activated users can see links., Click Here To Register... at the Only registered and activated users can see links., Click Here To Register... working at the Only registered and activated users can see links., Click Here To Register... He is Editor-in-Chief for Only registered and activated users can see links., Click Here To Register....
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