6 Furthermore, while misdiagnosed patients are receiving these unnecessary, potentially harmful, and costly medications, they are also going without treatment for their true diagnoses. The cost of DMT is rising, 5 with the median price in 2018 at $80,000. 3Īlong with these physical risks, MS DMTs come at a significant cost. Another contemporary study reported similar findings: In a group of 110 misdiagnosed patients, 70% had exposure to DMTs, and almost a quarter received a DMT with a known risk of PML. Almost half (48%) of the patients in the study received a DMT known to have the risk of progressive multifocal leukoencephalopathy (PML), a disabling and potentially fatal infection. 4 In the above-mentioned misdiagnosis study, more than half of the misdiagnosed patients received Food and Drug Administration (FDA)-approved DMTs including glatiramer acetate, dimethyl fumarate, natalizumab, and fingolimod as well as off-label medications, such as cyclophosphamide and methotrexate. Misdiagnosed patients often receive MS disease-modifying therapy (DMT) associated with various risks and side effects, 3 such as injection site or infusion reactions, flu-like symptoms, bradycardia, infection, and teratogenicity. Misdiagnosis of MS has physical, psychosocial, and financial ramifications. 3 Objective evidence of demyelinating disease and appropriate application of diagnostic criteria is necessary to prevent misdiagnosis. 2 Those who are misdiagnosed often carry the diagnosis for multiple years until being “undiagnosed,” some carrying the diagnosis for a decade or longer.
In a study of 2 independent MS referral centers, 18% of new patients referred with an established diagnosis of MS were deemed misdiagnosed. 1 Because there is no single highly specific biomarker for MS, misdiagnosis-when a patient without MS receives an incorrect diagnosis of MS-is unfortunately common. Accurate diagnosis of multiple sclerosis (MS) hinges on correct interpretation of a patient’s clinical history and radiologic studies.
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