Survey of diagnostic and treatment practices for multiple sclerosis in Russian Federation in comparison to European data

Introduction: The data of the survey of European (EU) neurologists on the methods of diagnosis and treatment of multiple sclerosis in Europe were compared with the data of the similar survey of neurologists of the Russian Federation (RF). Method: Seventy-five neurologists specialized in MS from RF completed questionnaires on radiologically isolated syndrome (RIS), clinically isolated syndrome (CIS), relapsing-remitting (RRMS), secondary progressive (SPMS), and primary progressive (PPMS) multiple sclerosis. Results: In the case of RIS, only 46% of neurologists from the RF recommended CSF analysis for oligoclonal IgG and only 54.3% performed magnetic resonance imaging (MRI) of the spinal cord, which is significantly lower than in the EU (78% and 80%, respectively). In the case of CIS, significantly more neurologists from the Russian Federation would have tested for antibodies to disorders of the optical spectrum of neuromyelitis (57% in the EU and 94% in the RF). In case of typical RRMS, more neurologists from the RF preferred to start with the second line of disease-modifying therapy (DMT), a lower percentage would choose dimethyl fumarate as the first line DMT (9% in the RF and 25% in the EU). In case of escalating therapy, the majority of EU respondents (68%) indicated that one relapse would be sufficient (only 28% in RF), while in RF, 58% indicated that two relapses would be sufficient (22% in EU). Fewer neu-rologists from RF would use fingolimod, natalizumab or mitoxantrone for SPMS. 91% of neurologists in RF would like to prescribe ocrelizumab for PPMS. Conclusion: MS specialists from RF are less active in monitoring RIS than MS specialists from EU. CIS is not indication to use any DMT in RF. MS specialists in RF are more conservative in changing DMT as escalation in cases with breakthrough RRMS. The products without indication to be used in SPMS are rarely prescribed in RF in comparison to EU. Most cases of PPMS in RF would be treated with ocrelizumab.