From Global Evidence to Saudi Practice: A Structured Evidence Map of the Diagnosis, Molecular Targets, and Therapeutic Strategies of Multiple Sclerosis in the Kingdom of Saudi Arabia.
- 1Prince Fahad Bin Sultan Chair for Biomedical Research, University of Tabuk, Tabuk 71491, Saudi Arabia.
- 2Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia.
- 3Department of Surgical Oncology, Faculty of Medicine, University of Tabuk, Tabuk 47512, Saudi Arabia.
Abstract
Multiple sclerosis (MS) has shifted in a generation from an uncommon diagnosis in Saudi Arabia to a major cause of neurological disability in young adults. Available Saudi data describe clinical characteristics broadly similar to those reported elsewhere in the Middle East and do not show that Saudi patients differ from trial populations, although this does not establish equivalent efficacy or safety. How far global advances are usable in the Kingdom has not, however, been synthesized. This narrative review maps diagnostic and therapeutic strategies across five separately reported domains (clinical evidence, 2022 national consensus listing, affordability, monitoring requirement, regional data), with categories assigned by a pre-specified rule, not a composite grade. Regional evidence on established therapies is entirely observational: cohorts report favourable outcomes with fingolimod, natalizumab, and off-label rituximab but cannot establish comparative effectiveness, and physicians report cost, availability, and insurance formularies as constraints whose extent has not been quantified. Diagnosis, now based on the 2024 McDonald revision, is transferable in knowledge but depends on AQP4-IgG testing, MRI, and biomarker capacity whose national distribution is undocumented, with neuromyelitis optica spectrum disorder an important differential. Tolebrutinib, recently approved in Europe for non-relapsing secondary progressive MS, and experimental modalities remain regulatory or research questions without regional data. Saudi studies document substantial payer costs of disease-modifying therapy, but none have measured how often cost or infrastructure alters treatment; we propose a prioritized research agenda.
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BibTeX
@article{mir2026from,
title = {{From Global Evidence to Saudi Practice: A Structured Evidence Map of the Diagnosis, Molecular Targets, and Therapeutic Strategies of Multiple Sclerosis in the Kingdom of Saudi Arabia.}},
author = {Rashid Mir and Naseh A Algehainy and Mohammed M Jalal and Malik A Altayar and Reema M Almotairi and Faris J Tayeb and Ruqaiah I Bedaiwi and Faisal H Altemani and Kholoud S Almasoudi and Ibrahim Altedlawi Albalawi and Eram Husain},
journal = {Diseases (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/diseases14100382},
url = {https://europepmc.org/article/MED/42930009},
note = {CC BY},
}
RIS
TY - JOUR
TI - From Global Evidence to Saudi Practice: A Structured Evidence Map of the Diagnosis, Molecular Targets, and Therapeutic Strategies of Multiple Sclerosis in the Kingdom of Saudi Arabia.
AU - Rashid Mir
AU - Naseh A Algehainy
AU - Mohammed M Jalal
AU - Malik A Altayar
AU - Reema M Almotairi
AU - Faris J Tayeb
AU - Ruqaiah I Bedaiwi
AU - Faisal H Altemani
AU - Kholoud S Almasoudi
AU - Ibrahim Altedlawi Albalawi
AU - Eram Husain
PY - 2026
DA - 2026/10/18
JO - Diseases (Basel, Switzerland)
DO - 10.3390/diseases14100382
UR - https://europepmc.org/article/MED/42930009
AB - Multiple sclerosis (MS) has shifted in a generation from an uncommon diagnosis in Saudi Arabia to a major cause of neurological disability in young adults. Available Saudi data describe clinical characteristics broadly similar to those reported elsewhere in the Middle East and do not show that Saudi patients differ from trial populations, although this does not establish equivalent efficacy or safety. How far global advances are usable in the Kingdom has not, however, been synthesized. This narrative review maps diagnostic and therapeutic strategies across five separately reported domains (clinical evidence, 2022 national consensus listing, affordability, monitoring requirement, regional data), with categories assigned by a pre-specified rule, not a composite grade. Regional evidence on established therapies is entirely observational: cohorts report favourable outcomes with fingolimod, natalizumab, and off-label rituximab but cannot establish comparative effectiveness, and physicians report cost, availability, and insurance formularies as constraints whose extent has not been quantified. Diagnosis, now based on the 2024 McDonald revision, is transferable in knowledge but depends on AQP4-IgG testing, MRI, and biomarker capacity whose national distribution is undocumented, with neuromyelitis optica spectrum disorder an important differential. Tolebrutinib, recently approved in Europe for non-relapsing secondary progressive MS, and experimental modalities remain regulatory or research questions without regional data. Saudi studies document substantial payer costs of disease-modifying therapy, but none have measured how often cost or infrastructure alters treatment; we propose a prioritized research agenda.
SN - 2079-9721
ER -