Revised MacDonald Criteria

Hi, I saw a thread on another website saying the MacDonald criteria is being refined and was announced at a conference this week. Does anyone on here know exactly how it is changing and what the differences are between the old and new criteria? Thanks.

And see also:

The big thing seems to be a move away from the “2 years between attacks” criteria, to a situation where you can get a Dx after just one attack.

The big question is when will neuros start applying the new criteria - remember that this could lead to more scripts for expensive DMDs, and trusts could well say"Sorry, no money".


I think some neuros have already been applying this. I was diagnosed last year after a single clinical attack (numb toes). An MRI which showed multiple lesions, some of which were enhanced, was said to show dissemination in space and time sufficient to diagnose MS. Unfortunately a diagnosis of MS alone is not sufficient for DMDs beyond those available for CIS. You need “active” or “highly active” RRMS. A second MRI (3 months after the first) showed 1 new lesion and this was sufficient to label me “active” and qualify me for Lem (l’d had no new relapses).

It is good news they are updating the criteria to allow more reliance on MRI evidence of sub- clinical activity - but they also need to move the needle for labelling people “active” /“highly active” for this to make a difference for access to DMDs - or will this automatically follow?