ArticleJournal of neurology2025
The use of high-efficacy disease-modifying therapies in multiple sclerosis: recommendations from an expert Delphi consensus.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Machine Learning-Based Prediction of Sleep Quality in Patients with Multiple Sclerosis.Medical sciences (Basel, Switzerland) · 2026Observational
- French expert opinion on the long-term management of relapsing multiple sclerosis with cladribine tablets beyond year 4.Journal of neurology · 2026Review
- Personalized medicine as a novel therapeutic approach for autoimmune diseases: new insights and future prospects.Osong public health and research perspectives · 2026Article
- Patient‑Reported Satisfaction in Relapsing-Remitting Multiple Sclerosis: Advantages of At‑Home Self‑Administered Subcutaneous Ofatumumab Versus Other High‑Efficacy Therapies.Drugs - real world outcomes · 2026Article
- Building Towards Initiation, Moderation, De-Escalation and Cessation of Disease-Modifying Treatments for Multiple Sclerosis in Greece: An Expert Panel Consensus Meeting.Brain sciences · 2026Article
- Serum Uric Acid Trajectories in Multiple Sclerosis: A 5-Year Longitudinal Comparison of High- and Moderate-Efficacy Therapies.Medical sciences (Basel, Switzerland) · 2026Article
- Ocrelizumab in early relapsing-remitting multiple sclerosis: first interim analysis of the MUSPO Italian prospective cohort.Journal of neurology · 2026Observational
- Personalizing Relapsing-Remitting Multiple Sclerosis Monitoring: Patient Acceptance of Serum Neurofilament Light Chain and the Role of Disease Knowledge.Journal of personalized medicine · 2026Article
- Real-world effectiveness and safety of ofatumumab in multiple sclerosis: a longitudinal study integrating clinical, cognitive, and MRI outcomes.Therapeutic advances in neurological disorders · 2026Article
- Construction and application of a quality evaluation indicator system for intravenous therapy nursing.BMC nursing · 2025Article
- Large language models as clinical decision-support tools in multiple sclerosis and neuromyelitis optica spectrum disorders: A comparative study of ChatGPT-4o and neurologists.Multiple sclerosis journal - experimental, translational and clinicalArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo establish recommendations based on an expert consensus on the early and appropriate use of high-efficacy disease-modifying therapies (HE-DMTs) in the management of multiple sclerosis (MS) patients, based on current clinical evidence and real-world practice in Italy. MATERIAL AND
methodsA Delphi panel comprising 65 neurologists from 54 Italian MS centers engaged in a two-round consensus process. Experts rated 43 statements across five domains: therapeutic goals, definitions of HE-DMT, MS patient profiling, and use of HE-DMT at diagnosis and later in MS course, using a 5-point Likert scale. A statement reached strong consensus if ≥80% of panelists agreed; whereas between 70% and 80% it was considered as moderate.
resultsIn Round 2, 53 experts completed the survey on 43 statements. Strong consensus was achieved for 33 (76.7%), and moderate consensus for 6 (14.0%) statements. Experts strongly supported early HE-DMT initiation to prevent irreversible disability, endorsed a multidimensional definitions of treatment efficacy, and recommended personalized approaches based on clinical, radiological, and biomarker indicators. Consensus supported initiating HE-DMTs in patients with poor prognostic features and identified magnetic resonance imaging (MRI) activity, neurodegeneration markers, and suboptimal clinical response as specific factors requiring escalation to HE-DMTs.
conclusionThis Italian Delphi underscores the importance of early, personalized HE-DMT use to optimize long-term outcomes in MS. The strong expert alignment reflects a paradigm shift toward proactive treatment and highlights actionable clinical, radiological, and biological indicators that should guide therapeutic decisions. These findings may support national policy changes and promote more equitable and evidence-based access to HE-DMTs across healthcare systems.
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