The results of the first randomized, placebo-controlled trial of dimethyl fumarate in a cohort of participants with radiologically isolated syndrome showed efficacy against the risk of a first clinical demyelinating event. The findings pave the way for preventive medicine in multiple sclerosis and highlight the need for more precise prognostication of risk.
This is a preview of subscription content, log in via an institution to check access.
References
McGinley, M. P., Goldschmidt, C. H. & Rae-Grant, A. D. Diagnosis and treatment of multiple sclerosis: a review. J. Am. Med. Assoc. 325, 765–779 (2021).
Amato, M. P. et al. Disease-modifying drugs can reduce disability progression in relapsing multiple sclerosis. Brain 143, 3013–3024 (2020).
Amato, M. P. et al. Secondary prevention in radiologically isolated syndromes and prodromal stages of multiple sclerosis. Front. Neurol. 13, 787160 (2022).
Okuda, D. T. et al. Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome. Neurology 72, 800–805 (2009).
Lebrun-Frenay, C. et al. Radiologically isolated syndrome: 10-year risk estimate of a clinical event. Ann. Neurol. 88, 407–417 (2020).
Okuda, D. T. et al. Dimethyl fumarate delays multiple sclerosis in radiologically isolated syndrome. Ann. Neurol. https://doi.org/10.1002/ana.26555 (2022).
Solomon, A. J., Naismith, R. T. & Cross, A. H. Misdiagnosis of multiple sclerosis: impact of the 2017 McDonald criteria on clinical practice. Neurology 92, 26–33 (2019).
Kaisey, M. et al. An update on diagnostic laboratory biomarkers for multiple sclerosis. Curr. Neurol. Neurosci. Rep. 22, 675–688 (2022).
Filippi, M. et al. Present and future of the diagnostic work-up of multiple sclerosis: the imaging perspective. J. Neurol. https://doi.org/10.1007/s00415-022-11488-y (2022).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
M.P.A. served on scientific advisory boards for and has received speaker honoraria and research support from Bayer Schering Pharma, Biogen Idec, Cellgene BMS, Merck Serono, Novartis, Roche and Sanofi Aventis; is co-Editor of Multiple Sclerosis journal; and serves on the editorial board of BMC Neurology. E.P. received compensation for travel grants, participation in advisory board and/or speaking activities from Biogen, Cellgene BMS, Merck Serono, Novartis, Roche, Sanofi and Teva; and serves on the editorial board of Frontiers in Neurology and Brain Sciences.
Rights and permissions
About this article
Cite this article
Amato, M.P., Portaccio, E. A first step towards preventive medicine in multiple sclerosis. Nat Rev Neurol 19, 134–135 (2023). https://doi.org/10.1038/s41582-022-00769-9
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41582-022-00769-9
- Springer Nature Limited