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The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations
The treatment landscape for relapsing forms of multiple sclerosis (RMS) has expanded considerably over the last 10 years with the approval of multiple new disease-modifying therapies (DMTs), and others in late-stage clinical development. All DMTs for RMS are believed to reduce central nervous system...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688209/ https://www.ncbi.nlm.nih.gov/pubmed/28879412 http://dx.doi.org/10.1007/s00415-017-8594-9 |
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author | Pardo, Gabriel Jones, David E. |
author_facet | Pardo, Gabriel Jones, David E. |
author_sort | Pardo, Gabriel |
collection | PubMed |
description | The treatment landscape for relapsing forms of multiple sclerosis (RMS) has expanded considerably over the last 10 years with the approval of multiple new disease-modifying therapies (DMTs), and others in late-stage clinical development. All DMTs for RMS are believed to reduce central nervous system immune-mediated inflammatory processes, which translate into demonstrable improvement in clinical and radiologic outcomes. However, some DMTs are associated with long-lasting effects on the immune system and/or serious adverse events, both of which may complicate the use of subsequent therapies. When customizing a treatment program, a benefit–risk assessment must consider multiple factors, including the efficacy of the DMT to reduce disease activity, the short- and long-term safety and immunologic profiles of each DMT, the criteria used to define switching treatment, and the risk tolerance of each patient. A comprehensive benefit–risk assessment can only be achieved by evaluating the immunologic, safety, and efficacy data for DMTs in the controlled clinical trial environment and the postmarketing clinical practice setting. This review is intended to help neurologists make informed decisions when treating RMS by summarizing the known data for each DMT and raising awareness of the multiple considerations involved in treating people with RMS throughout the entire course of their disease. |
format | Online Article Text |
id | pubmed-5688209 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-56882092017-11-30 The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations Pardo, Gabriel Jones, David E. J Neurol Review The treatment landscape for relapsing forms of multiple sclerosis (RMS) has expanded considerably over the last 10 years with the approval of multiple new disease-modifying therapies (DMTs), and others in late-stage clinical development. All DMTs for RMS are believed to reduce central nervous system immune-mediated inflammatory processes, which translate into demonstrable improvement in clinical and radiologic outcomes. However, some DMTs are associated with long-lasting effects on the immune system and/or serious adverse events, both of which may complicate the use of subsequent therapies. When customizing a treatment program, a benefit–risk assessment must consider multiple factors, including the efficacy of the DMT to reduce disease activity, the short- and long-term safety and immunologic profiles of each DMT, the criteria used to define switching treatment, and the risk tolerance of each patient. A comprehensive benefit–risk assessment can only be achieved by evaluating the immunologic, safety, and efficacy data for DMTs in the controlled clinical trial environment and the postmarketing clinical practice setting. This review is intended to help neurologists make informed decisions when treating RMS by summarizing the known data for each DMT and raising awareness of the multiple considerations involved in treating people with RMS throughout the entire course of their disease. Springer Berlin Heidelberg 2017-09-06 2017 /pmc/articles/PMC5688209/ /pubmed/28879412 http://dx.doi.org/10.1007/s00415-017-8594-9 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Review Pardo, Gabriel Jones, David E. The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations |
title | The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations |
title_full | The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations |
title_fullStr | The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations |
title_full_unstemmed | The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations |
title_short | The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations |
title_sort | sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688209/ https://www.ncbi.nlm.nih.gov/pubmed/28879412 http://dx.doi.org/10.1007/s00415-017-8594-9 |
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