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Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society

Untreated multiple sclerosis (MS) irretrievably leads to severe neurological impairment. In European health care systems, patient access to disease modifying therapies (DMT) is often confined to more advanced stages of the disease because of restrictions in reimbursement. A discrepancy in access to...

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Autores principales: Habek, Mario, Adamec, Ivan, Barun, Barbara, Bašić Kes, Vanja, Bogoje Raspopović, Andrijana, Duka Glavor, Klaudia, Gabelić, Tereza, Grzinčić, Tihana, Jukić, Mirjam, Jurašić, Miljenka-Jelena, Kiđemet-Piskač, Spomenka, Komšo, Milica, Rimac, Julija, Lazibat, Ines, Lukić, Branka, Marčinko, Anita, Matijaca, Meri, Ratković, Marija, Šapina, Lidija, Vuletić, Vladimira, Mirošević Zubonja, Tea, Krbot Skorić, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Croatian Medical Schools 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468732/
https://www.ncbi.nlm.nih.gov/pubmed/36046935
http://dx.doi.org/10.3325/cmj.2022.63.379
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author Habek, Mario
Adamec, Ivan
Barun, Barbara
Bašić Kes, Vanja
Bogoje Raspopović, Andrijana
Duka Glavor, Klaudia
Gabelić, Tereza
Grzinčić, Tihana
Jukić, Mirjam
Jurašić, Miljenka-Jelena
Kiđemet-Piskač, Spomenka
Komšo, Milica
Rimac, Julija
Lazibat, Ines
Lukić, Branka
Marčinko, Anita
Matijaca, Meri
Ratković, Marija
Šapina, Lidija
Vuletić, Vladimira
Mirošević Zubonja, Tea
Krbot Skorić, Magdalena
author_facet Habek, Mario
Adamec, Ivan
Barun, Barbara
Bašić Kes, Vanja
Bogoje Raspopović, Andrijana
Duka Glavor, Klaudia
Gabelić, Tereza
Grzinčić, Tihana
Jukić, Mirjam
Jurašić, Miljenka-Jelena
Kiđemet-Piskač, Spomenka
Komšo, Milica
Rimac, Julija
Lazibat, Ines
Lukić, Branka
Marčinko, Anita
Matijaca, Meri
Ratković, Marija
Šapina, Lidija
Vuletić, Vladimira
Mirošević Zubonja, Tea
Krbot Skorić, Magdalena
author_sort Habek, Mario
collection PubMed
description Untreated multiple sclerosis (MS) irretrievably leads to severe neurological impairment. In European health care systems, patient access to disease modifying therapies (DMT) is often confined to more advanced stages of the disease because of restrictions in reimbursement. A discrepancy in access to DMTs is evident between West and East European countries. In order to improve access to DMTs for people with MS (pwMS) living in Croatia, the Croatian Neurological Society issued new recommendations for the treatment of relapsing MS. The aim of this article is to present these recommendations. The recommendations for platform therapies are to start DMT as soon as the diagnosis is made. If poor prognostic criteria are present (≥9 T2 or FLAIR lesions on the initial brain and spinal cord magnetic resonance imaging [MRI] or ≥3 T1 lesions with postcontrast enhancement on the initial brain and spinal cord MRI or Expanded Disability Status Scale after treatment of the initial relapse ≥3), high-efficacy DMT should be initiated. If pwMS experience ≥1 relapse or ≥3 new T2 lesions while on platform therapies, they should be switched to high-efficacy DMT. Further efforts should be made to enable early and unrestricted access to high-efficacy DMT with a freedom of choice of an appropriate therapy for expert physicians and pwMS. The improvement of access to DMT achieved by the implementation of national treatment guidelines in Croatia can serve as an example to national neurological societies from other Eastern European countries to persuade payers to enable early and unrestricted treatment of pwMS.
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spelling pubmed-94687322022-09-29 Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society Habek, Mario Adamec, Ivan Barun, Barbara Bašić Kes, Vanja Bogoje Raspopović, Andrijana Duka Glavor, Klaudia Gabelić, Tereza Grzinčić, Tihana Jukić, Mirjam Jurašić, Miljenka-Jelena Kiđemet-Piskač, Spomenka Komšo, Milica Rimac, Julija Lazibat, Ines Lukić, Branka Marčinko, Anita Matijaca, Meri Ratković, Marija Šapina, Lidija Vuletić, Vladimira Mirošević Zubonja, Tea Krbot Skorić, Magdalena Croat Med J Review Untreated multiple sclerosis (MS) irretrievably leads to severe neurological impairment. In European health care systems, patient access to disease modifying therapies (DMT) is often confined to more advanced stages of the disease because of restrictions in reimbursement. A discrepancy in access to DMTs is evident between West and East European countries. In order to improve access to DMTs for people with MS (pwMS) living in Croatia, the Croatian Neurological Society issued new recommendations for the treatment of relapsing MS. The aim of this article is to present these recommendations. The recommendations for platform therapies are to start DMT as soon as the diagnosis is made. If poor prognostic criteria are present (≥9 T2 or FLAIR lesions on the initial brain and spinal cord magnetic resonance imaging [MRI] or ≥3 T1 lesions with postcontrast enhancement on the initial brain and spinal cord MRI or Expanded Disability Status Scale after treatment of the initial relapse ≥3), high-efficacy DMT should be initiated. If pwMS experience ≥1 relapse or ≥3 new T2 lesions while on platform therapies, they should be switched to high-efficacy DMT. Further efforts should be made to enable early and unrestricted access to high-efficacy DMT with a freedom of choice of an appropriate therapy for expert physicians and pwMS. The improvement of access to DMT achieved by the implementation of national treatment guidelines in Croatia can serve as an example to national neurological societies from other Eastern European countries to persuade payers to enable early and unrestricted treatment of pwMS. Croatian Medical Schools 2022-08 /pmc/articles/PMC9468732/ /pubmed/36046935 http://dx.doi.org/10.3325/cmj.2022.63.379 Text en Copyright © 2022 by the Croatian Medical Journal. All rights reserved. https://creativecommons.org/licenses/by/2.5/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Habek, Mario
Adamec, Ivan
Barun, Barbara
Bašić Kes, Vanja
Bogoje Raspopović, Andrijana
Duka Glavor, Klaudia
Gabelić, Tereza
Grzinčić, Tihana
Jukić, Mirjam
Jurašić, Miljenka-Jelena
Kiđemet-Piskač, Spomenka
Komšo, Milica
Rimac, Julija
Lazibat, Ines
Lukić, Branka
Marčinko, Anita
Matijaca, Meri
Ratković, Marija
Šapina, Lidija
Vuletić, Vladimira
Mirošević Zubonja, Tea
Krbot Skorić, Magdalena
Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society
title Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society
title_full Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society
title_fullStr Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society
title_full_unstemmed Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society
title_short Treatment of relapsing multiple sclerosis – recommendations of the Croatian Neurological Society
title_sort treatment of relapsing multiple sclerosis – recommendations of the croatian neurological society
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468732/
https://www.ncbi.nlm.nih.gov/pubmed/36046935
http://dx.doi.org/10.3325/cmj.2022.63.379
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