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31-08-2023 | Multiple Sclerosis | Original Communication

Real-life evaluation of the 2017 McDonald criteria for relapsing–remitting multiple sclerosis after a clinically isolated syndrome confirms a gain in time-to-diagnosis

Authors: Mickaël Ferrand, Jonathan Epstein, Marc Soudant, Francis Guillemin, Sophie Pittion-Vouyovitch, Marc Debouverie, Guillaume Mathey

Published in: Journal of Neurology | Issue 1/2024

Abstract

Background

Previous cohort studies evaluating the performances of the McDonald criteria suffered from bias regarding real-life conditions. We aimed to evaluate the probability of diagnosing relapsing–remitting multiple sclerosis (MS) at several timepoints from the first medical evaluation and the gain in time-to-diagnosis with the 2017 McDonald criteria compared with the 2001, 2005 and 2010 versions in real life.

Methods

Patients with a first demyelinating event suggestive of MS between 2002 and 2020 were included in the ReLSEP, an exhaustive and prospectively incremented registry of MS patients in North-Eastern France. We estimated the probability of being positive at the first medical evaluation and at five timepoints according to the four versions of criteria using Kaplan–Meier estimators and Cox models.

Results

A total of 2220 patients were followed up for a median of 7.1 years. At baseline, 31.7%, 32.1%, 36.6% and 54.0% of patients, respectively, fulfilled the 2001, 2005, 2010 and 2017 McDonald criteria. Using the 2017 criteria, the gain in time-to-diagnosis was 3.7 months compared with the 2010 criteria. The presence of intrathecal synthesis of immunoglobulin G in the McDonald 2017 criteria led to a 1.8-month reduction in median time-to-diagnosis compared to a version of McDonald 2017 without this criteria.

Conclusions

In real-life, the 2017 McDonald criteria revision undoubtedly shortened time-to-diagnosis.

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Title: Real-life evaluation of the 2017 McDonald criteria for relapsing–remitting multiple sclerosis after a clinically isolated syndrome confirms a gain in time-to-diagnosis
Authors: Mickaël Ferrand
Jonathan Epstein
Marc Soudant
Francis Guillemin
Sophie Pittion-Vouyovitch
Marc Debouverie
Guillaume Mathey
Publication date: 31-08-2023
Publisher: Springer Berlin Heidelberg
Keywords: Multiple Sclerosis
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Cranial MRI
Published in: Journal of Neurology / Issue 1/2024
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-11905-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Real-life evaluation of the 2017 McDonald criteria for relapsing–remitting multiple sclerosis after a clinically isolated syndrome confirms a gain in time-to-diagnosis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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