Neurológia pre prax 6/2020

Negative prognostic factors in multiple sclerosis

Multiple sclerosis is a heterogeneous disease with a variable prognosis. The choice of optimal treatment in the initial stages of the disease fundamentally affects its further course. It is an effort to find the most ideal prognostic factors that would differentiate patients at risk of higher clinical activity and progression of disability with the need to introduce more vigorous treatment. These indicators include demographic and clinical factors, magnetic resonance imaging findings, some laboratory biomarkers, and environmental factors. More information is provided by a comprehensive assessment of the forecast based on multivariate prediction models. Although a recent systematic review states that most of these prognostic factors are at high risk of bias and lacking external validation and impact analysis, this does not diminish their importance in clinical practice.

Keywords: multiple sclerosis, poor prognosis, magnetic resonance imaging, biomarkers