ECTRIMS/EAN Guideline on the pharmacological treatment of people with multiple sclerosis

被引：370

作者：

Montalban, Xavier ^{[1
]}

Gold, Ralf ^{[2
]}

Thompson, Alan J. ^{[3
,4
]}

Otero-Romero, Susana ^{[1
,5
]}

Amato, Maria Pia ^{[6
]}

Chandraratna, Dhia ^{[7
]}

Clanet, Michel ^{[8
]}

Comi, Giancarlo ^{[9
]}

Derfuss, Tobias ^{[10
,11
]}

Fazekas, Franz ^{[12
]}

Hartung, Hans Peter ^{[13
]}

Havrdova, Eva ^{[14
,15
,16
]}

Hemmer, Bernhard ^{[17
,18
]}

Kappos, Ludwig ^{[19
]}

Liblau, Roland ^{[20
,21
]}

Lubetzki, Catherine ^{[22
]}

Marcus, Elena ^{[23
]}

Miller, David H. ^{[24
,25
]}

Olsson, Tomas ^{[26
]}

Pilling, Steve ^{[23
]}

Selmaj, Krysztof ^{[27
]}

Siva, Axel ^{[28
,29
]}

Sorensen, Per Soelberg ^{[30
]}

Sormani, Maria Pia ^{[31
]}

Thalheim, Christoph ^{[32
]}

Wiendl, Heinz ^{[33
]}

Zipp, Frauke ^{[34
]}

机构：

[1] Vall dHebron Univ Hosp, Dept Neurol Neuroimmunol, Multiple Sclerosis Ctr Catalonia Cemcat, Pg Vall dHebron 119-129, Barcelona 08035, Spain

[2] Ruhr Univ, Dept Neurol, St Josef Hosp, Gudrunstr 56, D-44791 Bochum, Germany

[3] UCL, Inst Neurol, Dept Brain Repair & Rehabil, London, England

[4] UCL, Inst Neurol, Fac Brain Sci, London, England

[5] Vall dHebron Univ Hosp, Prevent Med & Epidemiol Dept, Barcelona, Spain

[6] Univ Florence, Dept Neurosci Psychol Drugs & Child Hlth Area NEU, Sect Neurosci, Florence, Italy

[7] Multiple Sclerosis Int Federat, London, England

[8] Toulouse Univ Hosp, Dept Neurol, Toulouse, France

[9] Univ Vita Salute San Raffaele, Dept Neurol, Inst Expt Neurol INSPE, Sci Inst Hosp, Milan, Italy

[10] Univ Hosp Basel, Dept Neurol, Basel, Switzerland

[11] Univ Hosp Basel, Dept Biomed, Basel, Switzerland

[12] Med Univ Graz, Dept Neurol, Graz, Austria

[13] Heinrich Heine Univ Dusseldorf, Multiple Sclerosis Ctr, Dept Neurol, Fac Med, Dusseldorf, Germany

[14] Charles Univ Prague, Dept Neurol, Prague, Czech Republic

[15] Charles Univ Prague, Ctr Clin Neurosci, Fac Med 1, Prague, Czech Republic

[16] Charles Univ Prague, Gen Univ Hosp, Prague, Czech Republic

[17] Tech Univ Munich, Dept Neurol, Klinikum Rechts Isar, Munich, Germany

[18] Munich Cluster Syst Neurol SyNergy, Munich, Germany

[19] Univ Hosp Basel, Basel, Switzerland

[20] Univ Toulouse, INSERM, UMR U1043, CNRS,U5282, Toulouse, France

[21] UPS, Ctr Physiopathol Toulouse Purpan, Toulouse, France

[22] UPMC Univ Paris 06, Sorbonne Univ, UMR S 1127, ICM GHU Pitie Salpetriere, Paris, France

[23] UCL, Ctr Outcomes Res & Effectiveness, Res Dept Clin Educ & Hlth Psychol, London, England

[24] UCL, Inst Neurol, NMR Res Unit, London, England

[25] UCL, Inst Neurol, Queen Sq Multiple Sclerosis Ctr, London, England

[26] Karolinska Univ, Hosp Solna, Neuroimmunol Unit, Ctr Mol Med, Stockholm, Sweden

[27] Med Univ Lodz, Dept Neurol, Lodz, Poland

[28] Istanbul Univ, Clin Neuroimmunol Unit, Cerrahpasa Med Sch, Istanbul, Turkey

[29] Istanbul Univ, MS Clin, Cerrahpasa Med Sch, Dept Neurol, Istanbul, Turkey

[30] Rigshosp, Copenhagen Univ Hosp, Dept Neurol, Danish Multiple Sclerosis Ctr, Copenhagen, Denmark

[31] Univ Genoa, Biostat Unit, Genoa, Italy

[32] European Multiple Sclerosis Platform EMSP, Schaerbeek, Belgium

[33] Univ Munster, Dept Neurol, Munster, Germany

[34] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Neurol,Rhine Main Neurosci Network Rmn2, Focus Program Translat Neurosci FTN & Immunol FZI, Mainz, Germany

来源：

MULTIPLE SCLEROSIS JOURNAL | 2018年 / 24卷 / 02期

关键词：

Multiple sclerosis; guideline; disease-modifying therapies; GRADE methodology; DISEASE-MODIFYING DRUGS; SUBCUTANEOUS INTERFERON BETA-1A; PLACEBO-CONTROLLED TRIAL; RELEASE DIMETHYL FUMARATE; HIGH-YIELD PROCESS; DOUBLE-BLIND; GLATIRAMER ACETATE; PREGNANCY OUTCOMES; CONTROLLED PHASE-3; FOLLOW-UP;

D O I：

10.1177/1352458517751049

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Multiple sclerosis (MS) is a complex disease with new drugs becoming available in the past years. There is a need for a reference tool compiling current data to aid professionals in treatment decisions. Objectives: To develop an evidence-based clinical practice guideline for the pharmacological treatment of people with MS. Methods: This guideline has been developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology and following the updated EAN recommendations. Clinical questions were formulated in Patients-Intervention-Comparator-Outcome (PICO) format and outcomes were prioritized. The quality of evidence was rated into four categories according to the risk of bias. The recommendations with assigned strength (strong and weak) were formulated based on the quality of evidence and the risk-benefit balance. Consensus between the panelists was reached by use of the modified nominal group technique. Results: A total of 10 questions were agreed, encompassing treatment efficacy, response criteria, strategies to address suboptimal response and safety concerns and treatment strategies in MS and pregnancy. The guideline takes into account all disease-modifying drugs approved by the European Medicine Agency (EMA) at the time of publication. A total of 21 recommendations were agreed by the guideline working group after three rounds of consensus. Conclusion: The present guideline will enable homogeneity of treatment decisions across Europe.

引用

页码：96 / 120

页数：25

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