Portuguese Consensus for the Evaluation of the Multiple Sclerosis Treatment Response: A Delphi Panel

Introduction: Multiple sclerosis management has progressed significantly due to the development of novel treatments. Thus, assessing the patients’ treatment response is essential to optimize therapeutic decisions. This study aimed to establish a national consensus on the assessment and monitoring of the response to multiple sclerosis treatment with disease-modifying therapies. Methods: The Delphi methodology was employed, and two rounds of votes were performed. The statements that did not reach consensus (<80%) in the first round were submitted to a new assessment by the panel. Results: Thirty-eight Neurologists participated in the first round and 33 participated in the second round (86.8% response rate). In total, 38 statements (71.7%) reached consensus. In a general manner, consensus was reached for the statements related to assessment and monitorization of response to treatment. Statements for which no consensus was reached were related to less established response evaluation criteria, such as assessment by optical coherence tomography. Additionally, a lack of consensus was observed for the statements where the obtained evaluation makes it difficult to define suboptimal response to treatment and for shorter or longer monitoring times. Conclusion: This work highlights the importance of assessing the response to disease-modifying treatments in patients with multiple sclerosis and provides a set of criteria for this evaluation, established by a comprehensive panel of Portuguese experts. A more comprehensive analysis, which includes different parameters, was consensually agreed to be the best assessment strategy.