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Iranian Specialists’ Approach to Treatment Escalation in Multiple Sclerosis Patients With Cognitive Impairment Publisher



Ghadiri F1 ; Asadollahzadeh E1 ; Ebadi Z1 ; Sahraian MA1 ; Azimi A1 ; Navardi S1 ; Heidari H1 ; Abna Z1 ; Aboutorabi M2 ; Adibi I3, 4 ; Baghbanian SM5 ; Paybast S1 ; Poursadeghfard M6 ; Hosseini S7 Show All Authors
Authors
  1. Ghadiri F1
  2. Asadollahzadeh E1
  3. Ebadi Z1
  4. Sahraian MA1
  5. Azimi A1
  6. Navardi S1
  7. Heidari H1
  8. Abna Z1
  9. Aboutorabi M2
  10. Adibi I3, 4
  11. Baghbanian SM5
  12. Paybast S1
  13. Poursadeghfard M6
  14. Hosseini S7
  15. Shahmohammadi S1
  16. Ghaffari M8
  17. Ghalyanchilangroodi H9
  18. Ghiasian M10
  19. Kamali H11
  20. Kouchaki E12
  21. Mahrabi F13
  22. Mohammadianinejad E1
  23. Nahayati MA14
  24. Moghadasi AN1
Show Affiliations
Authors Affiliations
  1. 1. Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Neurology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  3. 3. Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Neurology, Booalicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
  6. 6. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  7. 7. Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  8. 8. Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  9. 9. Center for Clinical Research and Development, Ghaem International Hospital, Rasht, Iran
  10. 10. Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
  11. 11. Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
  12. 12. Department of Neurology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
  13. 13. Department of Neurology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran
  14. 14. Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Source: Current Journal of Neurology Published:2023


Abstract

Background: People with multiple sclerosis (MS) and their physicians recognize cognitive retention as an important desired outcome of disease-modifying therapies (DMTs). In this study, we attempted to gather the opinions of Iranian MS experts regarding the treatment approach toward clinical cases with different physical and cognitive conditions. Methods: Opinions of 20 MS specialists regarding the best approach to 6 case scenarios (with different clinical, cognitive, and imaging characteristics) were gathered via a form. Results: The estimated kappa of 0.16 [95% confidence interval (CI): 0.159-0.163; P < 0.001] suggested a poor degree of agreement on the treatment choice among the professionals. Conclusion: Although most specialists agreed with treatment escalation in cases with cognitive impairment, there was no general agreement. Furthermore, there was not enough clinical evidence in the literature to develop consensus guidelines on the matter. © 2023 Iranian Neurological Association, and Tehran University of Medical Sciences.
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