Identification of patients with relapsing multiple sclerosis eligible for high-efficacy therapies

Relapsing multiple sclerosis (RMS) presents a highly variable clinical evolution among patients, and its management should be personalized. Although there is no cure at present, effective disease-modifying therapies (DMTs) are available. Selection of the most appropriate DMT for each patient is infl...

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Bibliographic Details
Published in:Neurodegenerative disease management 2021-06, Vol.11 (3), p.251-261
Main Authors: Meca-Lallana, José, García-Merino, Juan Antonio, Martínez-Yélamos, Sergio, Vidal-Jordana, Angela, Costa, Lucienne, Eichau, Sara, Rovira, Àlex, Brieva, Luis, Agüera, Eduardo, Zarranz, Alfredo Rodríguez-Antigüedad
Format: Article
Language:English
Subjects:
disease-modifying therapies
highly active multiple sclerosis
multiple sclerosis
therapeutic decision-making
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Summary:Relapsing multiple sclerosis (RMS) presents a highly variable clinical evolution among patients, and its management should be personalized. Although there is no cure at present, effective disease-modifying therapies (DMTs) are available. Selection of the most appropriate DMT for each patient is influenced by several clinical, radiological and demographic aspects as well as personal preferences that, at times, are not covered in the regulatory criteria. This may be a source of difficulty, especially in certain situations where so-called ‘high-efficacy DMTs’ (usually considered second-line) could be of greater benefit to the patient. In this narrative review, we discuss evidence and experience, and propose a pragmatic guidance on decision-making with respect to the indication and management of high-efficacy DMT in adult patients with RMS based on expert opinion.
ISSN:1758-2024
1758-2032
DOI:10.2217/nmt-2020-0049