Sequencing of high-efficacy disease-modifying therapies in multiple sclerosis: perspectives and approaches

Neural Regeneration Research
Francois Grand'MaisonRobyn Schecter

Abstract

Multiple sclerosis (MS) is characterized by chronic inflammation in conjunction with neurodegeneration within the central nervous system. Most individuals with MS begin with a relapsing remitting course that later transitions to secondary progressive MS. Currently available disease-modifying therapies (DMTs) for relapsing MS have been demonstrated to reduce disease activity, however most patients require a change in therapy over the course of their disease. Treatment goals include the prevention of relapses and disability accumulation and to achieve this objective requires careful planning. Sequencing of DMTs for individual patients should be designed in such a way to maximize disease control and minimize risk based on the mechanism of action, pharmacokinetic and pharmacodynamic properties of each therapy. This includes the DMT patients are being switched from to those they are being switched to. The reversibility of immune system effects should be a key consideration for DMT sequence selection. This feature varies across DMTs and should factor more prominently in decision making as newer treatments become available for the prevention of disability accumulation in patients with progressive MS. In this short review, we discuss t...Continue Reading

References

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Citations

Sep 26, 2020·Therapeutic Advances in Neurological Disorders·Raed AlroughaniAly Ezzat
Oct 18, 2020·Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists·Elena Lozano-SotoJavier J González-Rosa
Oct 9, 2021·Multiple Sclerosis : Clinical and Laboratory Research·Michael ZhongVilija G Jokubaitis

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Methods Mentioned

BETA
immunodepletion

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