Treatment Optimization in Multiple Sclerosis: Canadian MS Working Group Recommendations

被引:83
作者
Freedman, Mark S. [1 ,2 ]
Devonshire, Virginia [3 ]
Duquette, Pierre [4 ]
Giacomini, Paul S. [5 ]
Giuliani, Fabrizio [6 ]
Levin, Michael C. [7 ]
Montalban, Xavier [8 ]
Morrow, Sarah A. [9 ]
Oh, Jiwon [8 ]
Rotstein, Dalia [8 ]
Yeh, E. Ann [10 ]
机构
[1] Univ Ottawa, Ottawa, ON, Canada
[2] Ottawa Hosp, Res Inst, Ottawa, ON, Canada
[3] Univ British Columbia, Vancouver, BC, Canada
[4] Ctr Hosp Univ Montreal, Montreal, PQ, Canada
[5] Montreal Neurol Hosp & Inst, Montreal, PQ, Canada
[6] Univ Alberta, Edmonton, AB, Canada
[7] Univ Saskatchewan, Saskatoon, SK, Canada
[8] St Michaels Hosp, Toronto, ON, Canada
[9] London Hlth Sci Ctr, London, ON, Canada
[10] Hosp Sick Children, Toronto, ON, Canada
关键词
MULTIPLE SCLEROSIS; THERAPEUTICS; Recommendations; Treatment optimization; Sequencing; DISEASE-MODIFYING THERAPY; CLINICALLY ISOLATED SYNDROME; LONG-TERM OUTCOMES; PLACEBO-CONTROLLED TRIAL; INTRAMUSCULAR INTERFERON BETA-1A; STEM-CELL TRANSPLANTATION; SECONDARY PROGRESSIVE MS; 1ST DEMYELINATING EVENT; DIGIT MODALITIES TEST; CENTRAL VEIN SIGN;
D O I
10.1017/cjn.2020.66
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The Canadian Multiple Sclerosis Working Group has updated its treatment optimization recommendations (TORs) on the optimal use of disease-modifying therapies for patients with all forms of multiple sclerosis (MS). Recommendations provide guidance on initiating effective treatment early in the course of disease, monitoring response to therapy, and modifying or switching therapies to optimize disease control. The current TORs also address the treatment of pediatric MS, progressive MS and the identification and treatment of aggressive forms of the disease. Newer therapies offer improved efficacy, but also have potential safety concerns that must be adequately balanced, notably when treatment sequencing is considered. There are added discussions regarding the management of pregnancy, the future potential of biomarkers and consideration as to when it may be prudent to stop therapy. These TORs are meant to be used and interpreted by all neurologists with a special interest in the management of MS.
引用
收藏
页码:437 / 455
页数:19
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