The diagnosis, categorization, and treatment of multiple sclerosis (MS) and other demyelinating diseases have shifted over the past decade, and many of the fundamental principles of MS pathogenesis and clinical course are being rewritten. Fundamental issues include selecting the right disease-modifying therapy for someone with active disease and how, or even if, patients with purely progressive MS should be treated. This article provides an overview and introduction to the current thinking in MS diagnosis and therapy with an emphasis on the data-driven and proactive approach that has come to define the current state of the art.
Address correspondence to Dr Stephen C. Krieger, Department of Neurology, Icahn School of Medicine at Mount Sinai, 5 E 98th St, New York, NY 10029, firstname.lastname@example.org.
Relationship Disclosure: Dr Krieger has served as a consultant for Acorda Therapeutics; Bayer AG; Biogen; EMD Serono, Inc; Genentech Inc; Novartis AG; Questcor Pharmaceuticals; Sanofi Genzyme; and Teva Pharmaceutical Industries Ltd. Dr Krieger has received personal compensation for speaking engagements from Biogen and research support for serving as a clinical trial medical monitor from the National Multiple Sclerosis Society.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Krieger reports no disclosure.