• Martin Marziniak, Karima Ghorab, Wojciech Kozubski, Claudia Pfleger, Lívia Sousa, Karen Vernon, Mauro Zaffaroni, and Sven G Meuth.
• Department of Neurology, kbo-Isar-Amper-Klinikum München-Ost, Ringstrasse 56A, 85540 Haar, Germany.
• Mult Scler Relat Disord. 2016 Jul 1; 8: 35-44.

AbstractIn the past 5 years, the combination of developments in diagnostic strategy and approval of new disease-modifying therapies has provided an opportunity to achieve dramatic improvements in patient outcomes in multiple sclerosis (MS). However, across Europe there are several factors that may prevent patients from receiving the best therapy at the appropriate time, and there is variation among countries in terms of which of these factors are most relevant. Here, we review current MS clinical practices in a number of countries in the European Union to identify differences regarding initiation of treatment in patients with clinically isolated syndrome or relapsing-remitting MS, and differences in the timing of treatment switch or escalation. While recognizing that policy is not static in any country, we believe that patients' interests would be better served if a European treatment guideline was developed. Such a guideline could both inform and be informed by national policies, facilitating the dissemination of best clinical practice internationally. Copyright © 2016 Elsevier B.V. All rights reserved.

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