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Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists
BACKGROUND: In multiple sclerosis (MS), bridging therapies are usually administered when switching from one therapy to another. Such treatments generally consist of injectable immunomodulatory drugs (interferon or glatiramer acetate), whose efficacy, safety, and tolerability data are consolidated fo...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9337240/ https://www.ncbi.nlm.nih.gov/pubmed/35911920 http://dx.doi.org/10.3389/fneur.2022.898741 |
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author | Marfia, Girolama Alessandra Centonze, Diego Salvetti, Marco Ferraro, Elisabetta Panetta, Valentina Gasperini, Claudio Mirabella, Massimiliano Conte, Antonella |
author_facet | Marfia, Girolama Alessandra Centonze, Diego Salvetti, Marco Ferraro, Elisabetta Panetta, Valentina Gasperini, Claudio Mirabella, Massimiliano Conte, Antonella |
author_sort | Marfia, Girolama Alessandra |
collection | PubMed |
description | BACKGROUND: In multiple sclerosis (MS), bridging therapies are usually administered when switching from one therapy to another. Such treatments generally consist of injectable immunomodulatory drugs (interferon or glatiramer acetate), whose efficacy, safety, and tolerability data are consolidated for use even in fragile patients. We performed a nationwide survey to gather expert opinions regarding the most appropriate use of bridging therapies in MS. METHODS: An independent steering committee of Italian neurologists with expertise in MS treatment identified critical issues in the use of bridging therapies and formulated a questionnaire. This questionnaire was used to conduct a Delphi web survey, involving a panel of Italian neurologists with experience in MS treatment. Their anonymous opinions were collected in three sequential rounds. Consensus was defined as an interquartile range (IQR) ≤2. RESULTS: Responses were obtained from 38 experts (100%) in all three rounds. Injectable immunomodulatory drugs were considered first-line therapy in patients with mild-to-moderate disease activity and in women planning to become pregnant. In addition, the experts were confident about prescribing these drugs in patients at risk of cancer recurrence, while the panel agreed to discontinue any treatments in patients with uncontrolled cardiovascular or metabolic disorders. Moreover, bridging therapy with injectable immunomodulatory drugs was considered appropriate in order to protect the patient from disease reactivation when a prolonged washout was needed and also while waiting for the completion of the immunization schedule. CONCLUSION: The results of this nationwide survey confirm that, among Italian neurologists, there was wide agreement on the use of bridging therapies with injectable immunomodulatory drugs in several conditions in order to minimize the risk of disease reactivation when a prolonged washout was required or when the immunization schedule still needed to be completed in patients planning to become pregnant and in patients at risk of cancer recurrence. |
format | Online Article Text |
id | pubmed-9337240 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93372402022-07-30 Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists Marfia, Girolama Alessandra Centonze, Diego Salvetti, Marco Ferraro, Elisabetta Panetta, Valentina Gasperini, Claudio Mirabella, Massimiliano Conte, Antonella Front Neurol Neurology BACKGROUND: In multiple sclerosis (MS), bridging therapies are usually administered when switching from one therapy to another. Such treatments generally consist of injectable immunomodulatory drugs (interferon or glatiramer acetate), whose efficacy, safety, and tolerability data are consolidated for use even in fragile patients. We performed a nationwide survey to gather expert opinions regarding the most appropriate use of bridging therapies in MS. METHODS: An independent steering committee of Italian neurologists with expertise in MS treatment identified critical issues in the use of bridging therapies and formulated a questionnaire. This questionnaire was used to conduct a Delphi web survey, involving a panel of Italian neurologists with experience in MS treatment. Their anonymous opinions were collected in three sequential rounds. Consensus was defined as an interquartile range (IQR) ≤2. RESULTS: Responses were obtained from 38 experts (100%) in all three rounds. Injectable immunomodulatory drugs were considered first-line therapy in patients with mild-to-moderate disease activity and in women planning to become pregnant. In addition, the experts were confident about prescribing these drugs in patients at risk of cancer recurrence, while the panel agreed to discontinue any treatments in patients with uncontrolled cardiovascular or metabolic disorders. Moreover, bridging therapy with injectable immunomodulatory drugs was considered appropriate in order to protect the patient from disease reactivation when a prolonged washout was needed and also while waiting for the completion of the immunization schedule. CONCLUSION: The results of this nationwide survey confirm that, among Italian neurologists, there was wide agreement on the use of bridging therapies with injectable immunomodulatory drugs in several conditions in order to minimize the risk of disease reactivation when a prolonged washout was required or when the immunization schedule still needed to be completed in patients planning to become pregnant and in patients at risk of cancer recurrence. Frontiers Media S.A. 2022-07-15 /pmc/articles/PMC9337240/ /pubmed/35911920 http://dx.doi.org/10.3389/fneur.2022.898741 Text en Copyright © 2022 Marfia, Centonze, Salvetti, Ferraro, Panetta, Gasperini, Mirabella and Conte. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Marfia, Girolama Alessandra Centonze, Diego Salvetti, Marco Ferraro, Elisabetta Panetta, Valentina Gasperini, Claudio Mirabella, Massimiliano Conte, Antonella Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists |
title | Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists |
title_full | Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists |
title_fullStr | Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists |
title_full_unstemmed | Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists |
title_short | Bridging Therapies With Injectable Immunomodulatory Drugs in the Management of Multiple Sclerosis: A Delphi Survey of an Italian Expert Panel of Neurologists |
title_sort | bridging therapies with injectable immunomodulatory drugs in the management of multiple sclerosis: a delphi survey of an italian expert panel of neurologists |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9337240/ https://www.ncbi.nlm.nih.gov/pubmed/35911920 http://dx.doi.org/10.3389/fneur.2022.898741 |
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