Caparó-Zamalloa César, Velásquez-Rimachi Victor, Mori Nicanor, Dueñas-Pacheco Wenzel Ivan, Huerta-Rosario Andrely, Farroñay-García Chandel, Molina Roberto A, Alva-Díaz Carlos
Basic Research Center in Dementias and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
Neurosonología, Clínica Delgado, Lima, Peru.
Front Neurol. 2021 Oct 21;12:667398. doi: 10.3389/fneur.2021.667398. eCollection 2021.
Relapsing-remitting multiple sclerosis (RRMS) is a subtype of degenerative inflammatory demyelinating disease of multifactorial origin that affects the central nervous system and leads to multifocal neurological impairment. To develop a clinical pathway (CP) for the management of Peruvian patients with RRMS. First, we performed a literature review using Medline, Embase, Cochrane, ProQuest, and Science direct. Then, we structured the information as an ordered and logical series of five topics in a defined timeline: (1) How should MS be diagnosed? (2) How should a relapse be treated? (3) How should a DMT be initiated? (4) How should each DMT be used? and (5) How should the patients be followed? The personnel involved in the care of patients with RRMS can use a series of flowcharts and diagrams that summarize the topics in paper or electronic format. We propose the first CP for RRMS in Peru that shows the essential steps for diagnosing, treating, and monitoring RRMS patients based on an evidence-based medicine method and local expert opinions. This CP will allow directing relevant clinical actions to strengthen the multidisciplinary management of RRMS in Peru.
复发缓解型多发性硬化症（RRMS）是一种多因素起源的退行性炎性脱髓鞘疾病的亚型，它会影响中枢神经系统并导致多灶性神经功能障碍。为制定针对秘鲁RRMS患者的临床路径（CP）。首先，我们使用Medline、Embase、Cochrane、ProQuest和Science direct进行了文献综述。然后，我们在规定的时间范围内将信息整理成关于五个主题的有序且合乎逻辑的系列：（1）MS应如何诊断？（2）复发应如何治疗？（3）应如何启动疾病修正治疗（DMT）？（4）每种DMT应如何使用？以及（5）应如何对患者进行随访？参与RRMS患者护理的人员可以使用一系列以纸质或电子形式总结这些主题的流程图和图表。我们提出了秘鲁首个RRMS临床路径，该路径基于循证医学方法和当地专家意见展示了诊断、治疗和监测RRMS患者的基本步骤。此临床路径将有助于指导相关临床行动，以加强秘鲁RRMS的多学科管理。
