Contributions
Abstract: 229
Type: Oral
Introduction: There has been a major increase in disease modifying therapies (DMTs) for multiple sclerosis treatment in the past 15 years since the last AAN guideline in 2002. Decision making about starting, switching and stopping DMTs is complex and guidance about the use of these medications is of importance to clinical neurologists and patients with multiple sclerosis (MS).
Methods: At the direction of the AAN guideline development, dissemination and implementation committee (GDDI) a panel consisting of experts in MS, methodologists, GDDI members, and patients with MS performed a systematic review and developed a clinical practice guideline on the use of DMT in MS patients. We used the AAN GDDI amended 2011 protocol for guideline development. Questions we studied included patients with relapsing remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS), and clinically isolated syndromes of demyelination. We performed a systematic review of DMTs in MS including FDA approved medications and other medications in standard clinical use for MS disease management. We also utilized available Cochrane reviews after using AMSTAR (A Measurement Tool to Assess Systematic Reviews) grading. We extracted data from pertinent studies and used AAN GDDI 2016 process for evaluation of evidence: independent abstract selection with adjudication, data extraction, mGRADE classification of evidence. We used a standardized method to develop recommendations and developed a rationale for each recommendation supported by one or more of: evidence, principles of care, related evidence, and or inference. We assigned levels of obligation using an eConsensus modified Delphi process. Patients were engaged in multiple levels of guideline development; inclusion of patients on the guideline panel, public engagement during protocol and question development, public engagement during review of the systematic review and recommendations. Recommendations for future research as well as methodologies for dissemination and implementation were developed.
Results: Depending on the status of publication of this guideline in Neurology, we will present either the process we used to develop this guideline, or the process and results of the systematic review and recommendations.
Conclusions: The use of disease modifying therapy in MS is complex and guidance on appropriate use of these medications in clinical care is critical.
Disclosure: Dr. Rae-Grant has no disclosures related to this presentation.
Abstract: 229
Type: Oral
Introduction: There has been a major increase in disease modifying therapies (DMTs) for multiple sclerosis treatment in the past 15 years since the last AAN guideline in 2002. Decision making about starting, switching and stopping DMTs is complex and guidance about the use of these medications is of importance to clinical neurologists and patients with multiple sclerosis (MS).
Methods: At the direction of the AAN guideline development, dissemination and implementation committee (GDDI) a panel consisting of experts in MS, methodologists, GDDI members, and patients with MS performed a systematic review and developed a clinical practice guideline on the use of DMT in MS patients. We used the AAN GDDI amended 2011 protocol for guideline development. Questions we studied included patients with relapsing remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS), and clinically isolated syndromes of demyelination. We performed a systematic review of DMTs in MS including FDA approved medications and other medications in standard clinical use for MS disease management. We also utilized available Cochrane reviews after using AMSTAR (A Measurement Tool to Assess Systematic Reviews) grading. We extracted data from pertinent studies and used AAN GDDI 2016 process for evaluation of evidence: independent abstract selection with adjudication, data extraction, mGRADE classification of evidence. We used a standardized method to develop recommendations and developed a rationale for each recommendation supported by one or more of: evidence, principles of care, related evidence, and or inference. We assigned levels of obligation using an eConsensus modified Delphi process. Patients were engaged in multiple levels of guideline development; inclusion of patients on the guideline panel, public engagement during protocol and question development, public engagement during review of the systematic review and recommendations. Recommendations for future research as well as methodologies for dissemination and implementation were developed.
Results: Depending on the status of publication of this guideline in Neurology, we will present either the process we used to develop this guideline, or the process and results of the systematic review and recommendations.
Conclusions: The use of disease modifying therapy in MS is complex and guidance on appropriate use of these medications in clinical care is critical.
Disclosure: Dr. Rae-Grant has no disclosures related to this presentation.