Prognostic factors in multiple sclerosis

I. INTRODUCTION Since the introduction of long-term disease-modifying treatments such as interferon-ß to clinical practice (1) there has been an increasing tendency to initiate treatment early in the course of disease of patients with MS. A need for treatments that act early and over the long term is evident from growing evidence that irreversible axonal damage begins early (2) and disability accumulates over time. However, to maximize the long-term benefit and minimize toxicity of a treatment, physicians should select the right patient at the right stage of disease. Given the short follow-up periods of clinical trials relative to time over which disability develops in MS, the need to demonstrate long-term benefit of these chronic treatments is evident. Especially in the setting of expensive and dedicated treatment strategies, physicians need reliable measures to predict the course and outcome of MS in order to initiate treatment early.