Table 2.
Latin American survey on multiple sclerosis: questions posed and percentage answers (n = 204).
| Diagnosis |
| 1. Do you find clinical criteria useful? Do you use clinical criteria in your daily practice? |
| 99% of the respondents considered that diagnostic criteria (McDonald, as revised in 2005) are useful, and 92% of them answered that they used these criteria in their clinical practice. |
| 2. Do you have easy access to oligoclonal bands detection by isoelectric focusing? |
| 55% of respondents declared that they have no access to oligoclonal bands detection in cerebrospinal fluid. |
| 3. Do you have easy access to visual evoked potentials determination? |
| 82% of survey participants declared that there is adequate access to visual evoked potentials determination in their country. |
| 4. Do you have easy access to carrying out MRIs on your patients? When do you consider it necessary to perform MRIs? |
| 94% of respondents declared that they have sufficient access to MRI scans, and considered that the appropriate timepoints for MRI scans were upon diagnosis, every 6 months (if the diagnosis is not clear), once a year (irrespective of patient’s progression), with disease progression, and with relapses. |
| 5. In your country, are there any guidelines on the frequency of MRI scans? |
| 86% of survey participants declared that there are no guidelines regarding the frequency for MRI scans in their respective countries. |
| Treatment |
| 6. Do you agree with the treatment of CIS? |
| 92% of respondents considered that CIS must be treated. |
| 7. What is your first-line treatment choice? |
| Most of participating neurologists start treatment with glatiramer acetate or IFN beta-1a i.m., IFN beta-1a s.c. (22 µg or 44 µg), or IFN beta-1b. Some prescribe azathioprine as a starting drug because they do not have access to immunomodulating agents, or because these drugs are not covered by healthcare plans. |
| 8. Is the use of generic or biosimilar drugs approved in your country? |
| 64% of neurologists stated that the use of generic drugs is approved in their country. |
| Overall management |
| 9. Do you consider the annual number of relapses when defining treatment failure? How many relapses a year? |
| 96% of survey participants consider the number of annual relapses to determine whether there is treatment failure. Of these, 73% consider that there is treatment failure if the patient presents with two or more attacks per year, and 26%, if the patient presents with one or more relapses per year. |
| 10. When do you consider that a relapse has occurred? |
| 50% of respondents considered that patients have a relapse when symptoms persist at least for 24 h, while the rest opined that symptoms must persist at least for 48 h. |
| 11. Do you consider that progression is an indicator of treatment failure? Which factors do you take into account to define progression? |
| 90% of neurologists considered that progression is an indicator of treatment failure. Most of them defined progression based on a change in the EDSS score sustained for 6 months. |
| 12. Do you use assessment scales in your daily practice? If yes, which? |
| 96% of survey respondents stated that they were used to administering the EDSS, 62% with cognitive assessments, and 50% with MSF Composite. However, only 42% of participants stated that they administer any of these scales at each visit. Of these, 79% administer the EDSS, 15%, cognitive assessments, and 13%, the MSF Composite. |
CIS, clinically isolated syndrome; EDSS, Expanded Disability Status Scale; MRI, magnetic resonance imaging; MSF Composite, Multiple Sclerosis Functional Composite.