The new 2017 Japanese guidelines for multiple sclerosis and neuromyelitis optica : Key points and challenges for future guidelines

Abstract

Recently, the 2017 Japanese guidelines for multiple sclerosis (MS) and neuromyelitis optica (NMO), as well as the supplement of the 2017 guidelines for dimethyl fumarate have been published. The 2017 guidelines include outlines on MS, NMO, and six other central nervous system demyelinating diseases. Furthermore, they contain 110 clinical questions and general discussion on epidemiological and etiological studies that primarily pertain to MS and NMO. The guidelines also have a detailed discussion section on symptoms, disability measurements, diagnostic tests, diagnostic criteria, clinical course and prognosis. Additionally, they include information on medical economics and social resources. The guidelines further focus on therapeutic approaches. Specifically, they include recommendations on general treatment strategies, acute stage treatment, disease–modifying therapy and symptomatic treatment for sequelae following MS and NMO's relapse. The present review discusses key points of the 2017 Japanese guidelines and their application in the clinical practice. Furthermore, this review discusses additional tasks to focus on in future guidelines.