Consensus recommendations on multiple sclerosis management in Australia and New Zealand: part 1

被引：0

作者：

Shipley, Jessica ^{[1
,2
]}

Beharry, James ^{[3
]}

Yeh, Wei ^{[1
,2
]}

Seery, Nabil ^{[1
,2
]}

Foong, Yi Chao ^{[2
,4
]}

Ayton, Darshini ^{[2
]}

Siriratnam, Pakeeran ^{[1
,2
]}

Tan, Tracie ^{[1
,2
]}

Beadnall, Heidi ^{[5
]}

Barton, Joshua ^{[6
]}

Bridge, Francesca ^{[1
,2
]}

Wesselingh, Robb ^{[1
,2
]}

Taylor, Lisa ^{[7
]}

Rath, Louise ^{[1
]}

Haartsen, Jodi ^{[8
]}

Gadi, Mohammad ^{[9
,10
]}

Nesbitt, Cassie ^{[1
,2
,11
]}

Zhong, Michael ^{[1
,2
]}

Cushing, Victoria ^{[1
]}

Mckay, Fiona ^{[12
]}

Morahan, Julia ^{[12
]}

Trewin, Benjamin Peter ^{[13
,14
]}

Roos, Izanne ^{[7
,15
]}

Marriott, Mark ^{[7
,16
]}

Nguyen, Ai-Lan ^{[7
,15
]}

Downey, Emma ^{[1
]}

Crosby, Joanne ^{[1
]}

Bosco, Julian ^{[1
,2
]}

Taylor, Jennifer ^{[17
]}

Giles, Lauren ^{[18
]}

John, Nevin ^{[2
,19
]}

Butler, Ernest ^{[20
]}

van Der Walt, Anneke ^{[1
,2
]}

Butzkueven, Helmut ^{[1
,2
]}

Blum, Stefan ^{[21
]}

Simpson, Marion ^{[22
]}

Slee, Mark ^{[23
]}

Ramanathan, Sudarshini ^{[14
,24
]}

Hardy, Todd ^{[24
]}

Macdonell, Richard A. L. ^{[22
]}

Buzzard, Katherine ^{[7
,25
]}

Mason, Deborah F. ^{[3
,26
]}

Lechner-Scott, Jeannette ^{[27
,28
]}

Kilpatrick, Trevor J. ^{[7
,29
]}

Kalincik, Tomas ^{[7
,15
]}

Taylor, Bruce, V ^{[4
,30
]}

Broadley, Simon A. ^{[31
,32
]}

Reddel, Stephen ^{[5
,24
]}

Johnson, Douglas ^{[33
,34
]}

Monif, Mastura ^{[1
,2
]}

机构：

[1] ALFRED HLTH, Prahran, Vic, Australia

[2] Monash Univ, Monash Hlth, Au, Vic, Australia

[3] Christchurch Hosp, Christchurch, New Zealand

[4] Royal Hobart Hosp, Hobart, Tas, Australia

[5] Univ Sydney, Brain & Mind Ctr, Sydney, NSW, Australia

[6] Sunshine Coast Univ Hosp, Sunshine Coast, Qld, Australia

[7] Royal Melbourne Hosp, Neuroimmunol Ctr, Dept Neurol, Parkville, Vic, Australia

[8] Educ Au, Melbourne, Vic, Australia

[9] Educ Au, Melbourne, Vic, Australia

[10] Epworth Med Fdn, Monash Epworth Rehabil Res Ctr, Melbourne, Vic, Australia

[11] Barwon Hlth, Haematol, Geelong, Vic, Australia

[12] Univ Sydney, Sydney, NSW, Australia

[13] Univ Sydney, Sydney, NSW, Australia

[14] Univ Sydney, Kids Neurosci Ctr, Translat Neuroimmunol Grp, Sydney, NSW, Australia

[15] Univ Melbourne, Parkville, Vic, Australia

[16] Univ Melbourne, Melbourne Brain Ctr, Melbourne, Vic, Australia

[17] Wellington Hosp, Wellington, New Zealand

[18] Launceston Gen Hosp, Dept Gastroenterol, Launceston, Tas, Australia

[19] Monash Med Ctr, Clayton, Vic, Australia

[20] Peninsula Hlth, Oncol, Frankston, Vic, Australia

[21] Princess Alexandra Hosp, Woolloongabba, Qld, Australia

[22] Austin Hosp, Melbourne, Vic, Australia

[23] Flinders Univ S Australia, Adelaide, SA, Australia

[24] Concord Repatriat Gen Hosp, Concord, NSW, Australia

[25] Eastern Hlth, Gastroenterol, Melbourne, Vic, Australia

[26] Univ Otago, Christchurch, New Zealand

[27] John Hunter Hosp, Newcastle, NSW, Australia

[28] Univ Newcastle, Newcastle, NSW, Australia

[29] Florey Inst Neurosci & Mental Hlth, Parkville, Vic, Australia

[30] Univ Tasmania, Menzies Inst Med Res, Hobart, Tas, Australia

[31] Griffith Univ, Brisbane, Qld, Australia

[32] Gold Coast Univ Hosp, Gold Coast, Qld, Australia

[33] Royal Melbourne Hosp, Toorak, Vic, Australia

[34] Univ Melbourne, Parkville, Vic, Australia

来源：

MEDICAL JOURNAL OF AUSTRALIA | 2025年

关键词：

Multiple sclerosis; DISEASE-ACTIVITY; CONVERSION; THERAPY; MS; PLACEBO; BLIND;

D O I：

10.5694/mja2.52578

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

IntroductionMultiple sclerosis (MS) is a chronic inflammatory demyelinating and degenerative disease of the central nervous system. There were 33 335 people with MS in Australia in 2021 and 2917 in New Zealand in 2006 and the prevalence and incidence are increasing with time. Although new treatments have substantially improved outcomes in recent decades, the treatment landscape has become increasingly complex due to the expanding number of disease-modifying therapies (DMTs) and associated safety considerations. Main recommendationsA total of 80 consensus recommendations were developed on the current best-practice management of MS in Australia and New Zealand. Part 1 of these guidelines outlines the consensus recommendations covering domains including DMT counselling and selection, pre-DMT assessments, monitoring disease activity on DMT, switching DMT, and discontinuing DMT. The remaining recommendations are outlined in Part 2, encompassing risk mitigation strategies during treatment with DMT, managing DMT in special situations (including pregnancy, postpartum, breastfeeding, active infection including COVID-19, and malignancy), general lifestyle measures, acute MS relapses, and symptomatic treatments for MS. Changes in management as a result of the guidelinesThis two-part position statement provides a practical resource for clinicians on current best-practice consensus recommendations for managing adults (>= 18 years old) with MS in the Australian and New Zealand health care settings. It outlines the 14 DMTs currently available through the Australian Pharmaceutical Benefits Scheme and eight through the New Zealand Pharmaceutical Schedule, including the unique efficacy, safety and monitoring considerations of each. Through these guidelines, we aim to support safe, timely and effective management of patients with MS in Australia and New Zealand.

引用

页码：356 / 364

页数：9

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