Evidence map›Paper›PMID 39399557›Full record

ArticleNeurology. Clinical practice2025

Approach to Managing the Initial Presentation of Multiple Sclerosis: A Worldwide Practice Survey.

Jodie I Roberts, Aravind Ganesh, Luca Bartolini, Tomas Kalincik

Abstract read
In one paragraph

Article in Neurology. Clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Jodie I RobertsDepartment of Clinical Neurosciences (JIR, AG), University of Calgary, Canada; Neuroimmunology Centre (JIR, TK), Department of Neurology, Royal Melbourne Hospital; Clinical Outcomes Research Unit (JIR, TK), Department of Medicine, University of Melbourne, Australia; Hotchkiss Brain Institute (JIR, AG), University of Calgary, Canada; and Hasbro Children's Hospital (LB), Brown University, Providence, RI.ORCID https://orcid.org/0000-0002-8544-3171
Aravind GaneshDepartment of Clinical Neurosciences (JIR, AG), University of Calgary, Canada; Neuroimmunology Centre (JIR, TK), Department of Neurology, Royal Melbourne Hospital; Clinical Outcomes Research Unit (JIR, TK), Department of Medicine, University of Melbourne, Australia; Hotchkiss Brain Institute (JIR, AG), University of Calgary, Canada; and Hasbro Children's Hospital (LB), Brown University, Providence, RI.ORCID https://orcid.org/0000-0001-5520-2070
Luca BartoliniDepartment of Clinical Neurosciences (JIR, AG), University of Calgary, Canada; Neuroimmunology Centre (JIR, TK), Department of Neurology, Royal Melbourne Hospital; Clinical Outcomes Research Unit (JIR, TK), Department of Medicine, University of Melbourne, Australia; Hotchkiss Brain Institute (JIR, AG), University of Calgary, Canada; and Hasbro Children's Hospital (LB), Brown University, Providence, RI.ORCID https://orcid.org/0000-0003-2755-8218
Tomas KalincikDepartment of Clinical Neurosciences (JIR, AG), University of Calgary, Canada; Neuroimmunology Centre (JIR, TK), Department of Neurology, Royal Melbourne Hospital; Clinical Outcomes Research Unit (JIR, TK), Department of Medicine, University of Melbourne, Australia; Hotchkiss Brain Institute (JIR, AG), University of Calgary, Canada; and Hasbro Children's Hospital (LB), Brown University, Providence, RI.ORCID https://orcid.org/0000-0003-3778-1376

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Objectives: Available disease-modifying therapies (DMTs) for multiple sclerosis (MS) are rapidly expanding; although escalation approaches aim to balance safety and efficacy, emerging evidence suggests superior outcomes for people with MS who are exposed to early high-efficacy therapies. We aimed to explore practice differences in prevailing management strategies for relapsing-remitting MS. Methods: We used a worldwide electronic survey launched by the Practice Current section of Results: We received 153 responses from 42 countries; 32.3% responders identified as MS specialists. There was a strong preference for intravenous delivery of high-dose corticosteroids (87.7%, 95% CI 80.7-92.5), and most of the responders (61.3%, 95% CI 52.6-69.4) indicated they would treat a nondisabling (mild sensory) MS relapse. When asked to select a single initial DMT, 56.6% (95% CI 47.6-65.1) selected a high-efficacy therapy (67.5% MS specialists vs 53.7% non-MS specialists). The most selected agents overall were fingolimod (14.7%), natalizumab (15.5%), and dimethyl fumarate (20.9%). Two-thirds of respondents indicated they would request contrast-enhanced surveillance MRI. Discussion: Although there is a slight preference for initiating high-efficacy DMT at the time of initial MS diagnosis, opinions regarding the most appropriate treatment paradigm remain divided.

Identifiers

PMID39399557
PMCPMC11466530

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.