Disease modifying therapy switching in relapsing multiple sclerosis: A Delphi consensus of the demyelinating expert group of the Spanish society of neurology

被引：2

作者：

Brieva, Luis ^{[1
]}

Estruch, Bonaventura Casanova ^{[2
]}

Merino, Juan Antonio Garcia ^{[3
]}

Meca-Lallana, Virginia ^{[4
,5
]}

Rio, Jordi

Rodriguez-Antigueedad, Alfredo ^{[6
]}

Aguera, Eduardo ^{[7
]}

Ara, Jose Ramon ^{[8
]}

Luque, Adrian Ares ^{[9
]}

Garcia, Carmen Arnal ^{[10
]}

Blanco, Yolanda ^{[11
]}

Castillo-Trivino, Tamara ^{[12
]}

Costa-Frossard, Lucienne ^{[13
]}

Platas, Montserrat Gonzalez ^{[14
]}

Pascual, Lamberto Landete ^{[15
]}

Llaneza-Gonzalez, Miguel ^{[16
]}

Gines, Maria Luisa Martinez ^{[17
]}

Matias-Guiu, Jorge ^{[18
]}

Meca-Lallana, Jose E. ^{[19
]}

Bilbao, Mar Mendibe ^{[6
]}

Sempere, Angel Perez ^{[20
]}

Romero-Pinel, Lucia ^{[21
]}

Saiz, Albert ^{[22
]}

Moral, Ester ^{[23
,24
]}

机构：

[1] IRBLLEIDA, Hosp Arnau Vilanova, Lleida, Spain

[2] Hosp Universitari i Politecn Fe, Dept Neurol, Unit Neuroimmunol, Valencia, Spain

[3] Univ Autonoma Madrid, Fdn Invest Puerta Hierro, Madrid, Spain

[4] Hosp Univ Princesa, Dept Neurol, Multiple Sclerosis Unit, Madrid, Spain

[5] Hosp Univ Vall dHebron, Vall Hebron Inst Recerca, Ctr Esclerosi Multiple Catalunya, Serv Neurol Neuroimmunol, Barcelona, Spain

[6] Hosp Univ Cruces, Neuroimmunol & Multiple Sclerosis Unit, Baracaldo, Spain

[7] IMIBIC, Hosp Univ Reina Sofia, Neurol, Cordoba, Spain

[8] IIS Aragon, Hosp Univ Miguel Servet, Zaragoza, Spain

[9] Complejo Asistencial Univ Leon, Neurol, Leon, Spain

[10] Hosp Virgen Nieves, Granada, Spain

[11] Hosp Clin Barcelona, Un Neuroimmunol & Esclerosis multiple, Barcelona, Spain

[12] Biodonostia Hlth Res Inst, Neurol Dept, Basque Hlth Serv, Neurosci Area,Multiple Sclerosis Grp, San Sebastian, Spain

[13] Hosp Univ Ramon & Cajal, Fdn Invest Biomed IRyCIS, Serv Neurol, CSUR Esclerosis Multiple, Madrid, Spain

[14] Hosp Univ Canarias, Serv Neurol, Tenerife, Spain

[15] Hosp Univ Dr Peset, Serv Neurol, Valencia, Spain

[16] Complejo Hospitalario Univ Ferrol, Serv Neurol, La Coruna, Spain

[17] Hosp Gen Univ Gregorio Maranon, Serv Neurol, Madrid, Spain

[18] Univ Complutense Madrid, Hosp Clin San Carlos, Hlth Res Inst San Carlos IdISCC, Dept Neurol, Madrid, Spain

[19] IMIB Arrixaca, Hosp Clin Univ Virgen Arrixaca, Neurol Dept, CSUR Multiple Sclerosis & Clin Neuroimmunol Unit, Murcia, Spain

[20] Hosp Gen Univ Alicante, Neurol Serv, Alicante 03010, Spain

[21] Hosp Universitari Bellvitge IDIBELL, Dept Neurol, Multiple Sclerosis Unit, Lhospitalet De LLobregat, Barcelona, Spain

[22] Univ Barcelona, Hosp Clin, Inst Invest Biome August Pi Sunyer IDIBAPS d, Ctr Neuroimmunol, Barcelona, Spain

[23] Hosp Moises Broggi, Serv Neurol, Sant Joan Despi, Barcelona, Spain

[24] Hosp Gen Hospitalet, Serv Neurol, Lhospitalet De Llobregat, Barcelona, Spain

来源：

MULTIPLE SCLEROSIS AND RELATED DISORDERS | 2022年 / 63卷

关键词：

Relapsing multiple sclerosis; Disease modifying therapy; Benefit-risk; Therapy switching; Relapse; Washout period; INTERFERON-BETA; NATALIZUMAB; FINGOLIMOD; GUIDELINES; PREGNANCY; OUTCOMES; IMPACT; MRI;

D O I：

10.1016/j.msard.2022.103805

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: The increase in available disease modifying therapies (DMTs) for multiple sclerosis has led to greater emphasis on improving treatment sequencing paradigms. This article summarises the opinions from a panel of 25 experts on treatment switching approaches in relapsing multiple sclerosis (RMS).Methods: A modified Delphi consensus process was carried out to develop clinically relevant statements for aiding treatment decisions in patients with RMS between the 16th January and the 9th October 2019. A sub-group of two experts (core group) carried out an extensive review of the literature and formulated 106 statements for the expert panel to evaluate.Results: From a total number of 106 statements that were submitted to the expert panel for critical evaluation, consensus (at least 80% of the panelists agreed) was reached on 99 of them. These statements cover treatment objectives, reasons for DMT switching, suboptimal response criteria, strategies for treatment change and washout periods.Conclusion: The agreed statements provide up-to-date guidance on DMT sequencing for optimal patient management.

引用

页数：8

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