Guideline / position statementindependent cross-checkabstract checked★ key study I-AUTO-103 standard review
European MS treatment guideline
ECTRIMS/EAN Guideline on the pharmacological treatment of people with multiple sclerosis.
Overview
Montalban X et al.. Mult Scler 2018 · PMID 29353550 · DOI 10.1177/1352458517751049
European neurology societies recommend disease-modifying drugs for MS.
Does the study support the specific claim? No · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Guide MS drug treatment.
- How was the study done?
GRADE guideline.
- How many people, animals or samples were studied?
not applicable
- What was actually found?
21 recommendations on DMDs.
- How large was the observed effect?
not applicable
- What do the results mean in everyday life?
MS is treated with specific drugs.
- What are the study's limitations?
Not the newest edition.
- What does it say about Elawady's specific claim?
Contradicts diet as MS treatment.
- Do the results apply to Germany and Europe?
European standard.
- What can explicitly not be concluded from this study?
Role of diet as add-on.
Scientific in-depth review
1. Full reference
- Authors
- Montalban X et al.
- Journal
- Mult Scler
- Year
- 2018
- Identifier
- PMID 29353550 DOI 10.1177/1352458517751049
- Verification
- verified – PubMed efetch 2026-10-26; Crossref update-to/updated-by check
- Retracted
- no
- Corrections
ErratumIn Mult Scler 2020;26(4):517 (PubMed); Crossref lists corrections (10.1177/1352458520906383 and a further correction).
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Which pharmacological treatments should be used in MS?
3. Study design and population
- Study design
- Guideline / position statement – European clinical practice guideline (GRADE, PICO questions, modified nominal group consensus)
- Population
People with MS
- Country
Europe
- Period
not stated in abstract
- Sample size
not applicable (10 questions, 21 recommendations)
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
EMA-approved disease-modifying drugs
- Comparator
not applicable
- Endpoints
Recommendations
- Statistical methods
GRADE
5. Actual results
- Results
10 clinical questions; 21 recommendations covering efficacy, response criteria, strategies for suboptimal response, safety and pregnancy, covering all EMA-approved DMDs.
- Absolute risks
not reported
- Authors' conclusion
Guideline to enable homogeneous treatment decisions across Europe.
6. Strengths
- GRADE methodology
- European societies
7. Weaknesses
- 2018; newer drugs since
- Abstract only read
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Guideline.
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
Standard of care in Europe for MS is disease-modifying drug treatment; no recommendation for diet as replacement.
11. Independent contrary findings
12. Transferability to Germany and Europe
Universal biology; applies in Europe and Egypt.
13. Overall methodological judgement
Guideline-level contradiction of diet-only treatment.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |