The choice of the optimal therapeutic treatment is the question in each phase of the disease for a person with multiple sclerosis, whether it concerns the initiation of the treatment or the need to modify it.
The Canadian MS Working Group (Mark Freedman) (Review Article 2013&2020) developed practice guidelines in 2004
to assist clinicians in selecting optimal modifiable therapy for people with relapsing multiple sclerosis. Thus, practical criteria were developed for disease progression, EDSS scale progression, and CNS MRI imaging, which categorize the level of concern into Low, Medium, and High.
The above Working Group concluded that a change in treatment is likely when there is a High level of concern with a change in any of the three domains (impulses, progression, imaging). Medium in two of the three fields and Low in all three fields.
