037  Treating secondary progressive multiple sclerosis in the UK: use of guidelines and stopping criteria. Issue 6 (27th May 2022)

• Record Type: Journal Article
• Authors: Duddy, Martin; Wilkinson, Carmel; Rhys, Katherine; Medhurst, Steve
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 6(2022)
• Page Start: A25
• Page End: A25
• Publication Date: 2022-05-27
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-ABN.76
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: As new treatment approaches emerge for progressive forms of multiple sclerosis (MS), it is important to understand the factors underlying current practice. Methods: We used a structured questionnaire to interview 59 healthcare professionals (HCPs) from geo- graphically-dispersed UK MS centres about current disease modifying therapy (DMT) management of patients with suspected/confirmed secondary progressive MS (SPMS). Results: Of 43 HCPs (73%) who follow guidelines for DMT management of patients transitioning from relapsing-remitting multiple sclerosis (RRMS) to SPMS, most (n=37/43, 86%) use the NHS England (NHSE) algorithm; 7/43 (16%) use ABN guidance. Fifty-eight (98%) HCPs use DMTs to treat patients with RRMS whom they suspect may be transitioning to SPMS and 30 (51%) for (a minority of) patients with newly- diagnosed SPMS. Expanded Disability Status Scale (EDSS) 7.0 was the most frequently-reported criterion used for stopping DMTs (n=29, 49%), however, a variety of other criteria were used and a small majority of HCPs reported continuing DMTs beyond EDSS 7.0 in certain circumstances (most commonly recent relapse activity [n=32, 54%] or in younger patients [n=20, 34%]). Conclusions: Although most HCPs follow NHSE guidelines, a range of DMT stopping criteria are employed in clinical practice and treatment decisions may be based on individual patient circumstances. [e-mail]