{
  "abstract": "Objective\n\nTo gather expert consensus regarding initiation of monoclonal high-efficacy therapies (HET) amongst treatment-naïve relapsing-remitting multiple sclerosis (RRMS) patients in France.Methods\n\nThe study leveraged the Delphi method to gauge consensus amongst an expert panel of 31 neurologists. Eight clinical cases with demographic, clinical and imaging characteristics were presented, prompting the experts to respond if they would recommend monoclonal HET. Additionally, potentially influential parameters were changed one at a time to assess whether the experts would recommend monoclonal HET. After a first round, an e-workshop was conducted to discuss non-consensual statements, which were re-submitted for rating (Round 2). Characteristics influencing monoclonal HET initiation were evaluated.Results\n\n31/31 experts responded to both rounds. Consensus for or against monoclonal HET was reached for 89/108 (82.4%) statements. Factors that systematically led to monoclonal HET initiation were high brain lesion load (>20 lesions), ≥2 spinal cord lesions, ≥3 gadolinium-enhancing lesions and ≥3 infratentorial lesions. A single spinal cord lesion, in combination with other factors (which, in isolation, often but not always led to monoclonal HET), systematically led to monoclonal HET recommendation.Conclusion\n\nThis study suggests that the panel of French neurologists favoured monoclonal HET initiation amongst treatment-naïve RRMS patients with high radiological disease activity, whereas clinical characteristics played a complementary role.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology and Inserm, CIC-CRB 1404, CHU Rouen, F-76000, Rouen, France.",
    "Department of Neurology and Neurovascular Unit, Valence Hospital, Valence, France.",
    "Département de Neurologie, CRC sclérose en plaques, CRMR LEUKOFRANCE & Centre d'investigation clinique U1411, CHU de Montpellier, INM, INSERM, Univ Montpellier, Montpellier, France.",
    "Department of Neurology, European Hospital of Marseille, Marseille, France.",
    "Department of Neurology and Clinical Investigation Center, Strasbourg University Hospital, Strasbourg, France.",
    "Department of Neurology, Amiens University Hospital, Amiens, France.",
    "Neurology Unit, GHNE Paris Saclay Hospital, Orsay, France.",
    "UNIACT, Neurospin-INSERM UMR 1129, CEA, Université Paris-Saclay, Gif-sur-Yvette, France.",
    "INSERM U1172 LilNCog, Lille University Hospital, FHU Precise, University of Lille, Lille, France.",
    "Department of Neurology, CRC-SEP, Toulouse University Hospital, Toulouse, France. ciron.j@chu-toulouse.fr.",
    "INSERM UMR1291-CNRS UMR5051, INFINITY, University Toulouse III, Toulouse, France. ciron.j@chu-toulouse.fr."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bertrand Bourre",
      "orcid": "0000-0002-2459-2480"
    },
    {
      "affs": [
        1
      ],
      "name": "Olivier Guerrier",
      "orcid": "0009-0000-0311-3981"
    },
    {
      "affs": [
        2
      ],
      "name": "Xavier Ayrignac",
      "orcid": "0000-0003-3834-2981"
    },
    {
      "affs": [
        3
      ],
      "name": "Laurent Suchet",
      "orcid": "0000-0003-3189-2315"
    },
    {
      "affs": [
        4
      ],
      "name": "Jérôme de Seze",
      "orcid": "0000-0002-7197-7578"
    },
    {
      "affs": [
        5
      ],
      "name": "Ines Masmoudi",
      "orcid": "0009-0008-6959-3648"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Vito A G Ricigliano",
      "orcid": "0000-0002-8860-3548"
    },
    {
      "affs": [
        8
      ],
      "name": "Patrick Vermersch",
      "orcid": "0000-0003-0997-8817"
    },
    {
      "affs": [
        9,
        10
      ],
      "name": "Jonathan Ciron",
      "orcid": "0000-0002-3386-6308"
    },
    {
      "name": "CAReSEP working group"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/08wtjg9f6v9xj.bib",
  "cited_by": 0,
  "doi": "10.1007/s00415-026-14167-4",
  "fulltext_url": "https://europepmc.org/articles/PMC13690885",
  "id": "08wtjg9f6v9xj",
  "issns": [
    "0340-5354",
    "1432-1459"
  ],
  "landing_url": "https://europepmc.org/article/MED/42911241",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Multiple Sclerosis Research Studies"
    ]
  ],
  "openalex": "W7223181052",
  "pdf_url": "https://europepmc.org/articles/PMC13690885?pdf=render",
  "pmcid": "PMC13690885",
  "pmid": "42911241",
  "published": "2026-10-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/08wtjg9f6v9xj.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42911241",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42911241"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2734|Multiple Sclerosis Research Studies",
      "subfield": "general"
    }
  ],
  "title": "DELPHI expert consensus-derived factors influencing the early use of monoclonal high-efficacy therapies in treatment-naïve patients with relapsing-remitting multiple sclerosis.",
  "title_text": "DELPHI expert consensus-derived factors influencing the early use of monoclonal high-efficacy therapies in treatment-naïve patients with relapsing-remitting multiple sclerosis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/08wtjg9f6v9xj",
  "venue": "Journal of neurology",
  "versions": []
}