Defining the clinical course of multiple sclerosis: the 2013 revisions.
Defining the clinical course of multiple sclerosis: the 2013 revisions.
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DOI：
10.1212/wnl.0000000000000560
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发表时间：
2014-07-15
期刊：
影响因子：
9.9
通讯作者：
Polman CH
中科院分区：
文献类型：
--
作者：
Lublin FD;Reingold SC;Cohen JA;Cutter GR;Sørensen PS;Thompson AJ;Wolinsky JS;Balcer LJ;Banwell B;Barkhof F;Bebo B Jr;Calabresi PA;Clanet M;Comi G;Fox RJ;Freedman MS;Goodman AD;Inglese M;Kappos L;Kieseier BC;Lincoln JA;Lubetzki C;Miller AE;Montalban X;O'Connor PW;Petkau J;Pozzilli C;Rudick RA;Sormani MP;Stüve O;Waubant E;Polman CH
准确的多发性硬化（MS）临床病程描述（表型）对于临床试验的沟通、说明、设计和招募以及治疗决策非常重要。1996年发表的基于国际MS专家调查的标准化描述提供了基于当时数据和共识的纯临床表型，但缺乏成像和生物学相关性。对MS及其病理学的理解增加，加上对原始描述符可能无法充分反映最近发现的疾病临床方面的普遍关注，促使MS临床试验国际咨询委员会重新检查MS疾病表型。虽然缺乏可能提供分离临床表型的客观标准的成像和生物标志物，我们提出了包括疾病活动性（基于临床复发率和成像结果）和疾病进展考虑在内的精细描述符。未来的研究策略，以更好地定义表型也概述。
Accurate clinical course descriptions (phenotypes) of multiple sclerosis (MS) are important for communication, prognostication, design and recruitment of clinical trials, and treatment decision-making. Standardized descriptions published in 1996 based on a survey of international MS experts provided purely clinical phenotypes based on data and consensus at that time, but imaging and biological correlates were lacking. Increased understanding of MS and its pathology, coupled with general concern that the original descriptors may not adequately reflect more recently identified clinical aspects of the disease, prompted a re-examination of MS disease phenotypes by the International Advisory Committee on Clinical Trials of MS. While imaging and biological markers that might provide objective criteria for separating clinical phenotypes are lacking, we propose refined descriptors that include consideration of disease activity (based on clinical relapse rate and imaging findings) and disease progression. Strategies for future research to better define phenotypes are also outlined.