Educational reads on Chat GPT, paediatric MS, cladribine guidance, cognitive impairment

08/07/2024
Elena Kelly
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Educational reads on Chat GPT, paediatric MS, cladribine guidance, cognitive impairment

Updated guidance for cladribine issued by NICE 

England’s National Institute for Health and Care Excellence (NICE) has updated its guidance on the use of cladribine in people with aggressive RRMS in ways that should help eligible patients be able to access the medication sooner. 


The new guidelines have less stringent MRI criteria for defining quickly progressing and severe RRMS. A single MRI scan showing disease activity is now sufficient.


The changes are thought to better reflect clinical practice and will avoid the need for multiple MRI scans that can delay a person’s ability to start treatment..

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For more information on this topic, visit this webpage. 

High efficacy treatment in paediatric-onset MS 

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A recent study evaluated how high-efficacy therapies influence transitions across five disability states in people with paediatric-onset MS.

Longitudinal data were obtained from the international MSBase registry, including data from 5,224 children and adolescents with MS from 151 centres across 41 countries.

The results indicated that treatment of paediatric-onset MS with high-efficacy therapy substantially reduced the risk of reaching key disability milestones. This reduction in risk was most pronounced among young people with minimal or mild disability when treatment began. 

The authors concluded that children with RRMS should be treated early with high-efficacy therapy, before developing significant neurological impairments, to better preserve their neurological capacity.

Reference: Sharmin S, Roos I, Malpas CB, et al. Disease-modifying therapies in managing disability worsening in paediatric-onset multiple sclerosis: a longitudinal analysis of global and national registries. Lancet Child Adolesc Health. 2024;8(5):348-357

AI-based ChatGPT vs neurologists: a patient survey

ChatGPT is an open-source natural language processing software that replies to users' queries, offering an easy and convenient way for people to ask questions.

A study in Italy evaluated how people with MS respond to ChatGPT over advice from healthcare professionals. Two sets of answers to four common MS-related medical questions were developed, one written by ChatGPT and the other by a team of expert neurologists; these were distributed to 1,133 people with MS.

Satisfaction scores were similar for answers written by ChatGPT and neurologists, but those authored by ChatGPT were rated as significantly more empathetic than those written by doctors.

The authors concluded that within the progressive digitalisation of the population, ChatGPT could emerge as a helpful support in healthcare management rather than an alternative.

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Reference: Maida E, Moccia M, Palladino R, et al. ChatGPT vs. neurologists: a cross-sectional study investigating preference, satisfaction ratings and perceived empathy in responses among people living with multiple sclerosis. J Neurol. 2024 Apr 3. doi: 10.1007/s00415-024-12328-x.

Cognitive impairment and quality of life

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People with MS who have cognitive impairment tend to report worse mental and physical quality of life than patients who don’t have cognitive issues, a recent study reports. Adults with MS who have cognitive problems are also less likely to be employed.

The relationship between cognitive issues and quality of life for people with MS was analysed in a survey of 6,227 people using the North American Consortium of Multiple Sclerosis (NARCOMS) registry.

Reference: Lancia S, Marrie RA, Cutter G, Fox RJ, Salter A. Association of patient-reported cognitive impairment with quality of life and employment in multiple sclerosis. Mult Scler Relat Disord. 2024;87:105675

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