Annals of the New York Academy of Sciences · 2018 · 12 citations · 43 references
MedicineNeurologyDisease PreventionNeuroimmunologyPrecision MedicineLifestyle MedicineMultiple SclerosisBiomarker-based PrognosticationDisease Subtype ClassificationDisease Subtype IdentificationDisease Subtype StratificationModifying FactorsPrecision Medicine ApplicationsYoung Adulthood
Multiple sclerosis (MS) is a chronic, lifelong disease, currently without a cure that is responsible for significant neurological injury in young adults. Precision medicine for MS aims to provide a more exacting and refined approach toward management by providing recommendations based on disease subtype, clinical status, existing radiological data, para-clinical data, and other biological markers. To achieve better outcomes, the three stages of care-diagnosis, treatment, and management-should be optimized. However, as the temporal profile of disease behavior is highly variable in MS, and unlike outcomes from other chronic conditions (i.e., hypertension, diabetes mellitus, etc.), should precision medicine for MS be one that focuses more on disease prevention and lifestyle modifications beyond recommendations for the use of disease-modifying therapies? As scientific advancements continue within the field of neuroimmunology, and until reliable biomarkers that predict disease outcomes are available, success may be better achieved by focusing on modifiable factors to reduce future disability.
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Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria
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Defining the clinical course of multiple sclerosis
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Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis
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Xavier Montalbán, Stephen L. Hauser, Ludwig Kappos et al. · New England Journal of Medicine · 2016 · 1.9K citations · Full text
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