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Journal of Neurology
Published in: Journal of Neurology 12/2017

Open Access 01-12-2017 | Review

The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations

Authors: Gabriel Pardo, David E. Jones

Published in: Journal of Neurology | Issue 12/2017

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Abstract

The treatment landscape for relapsing forms of multiple sclerosis (RMS) has expanded considerably over the last 10 years with the approval of multiple new disease-modifying therapies (DMTs), and others in late-stage clinical development. All DMTs for RMS are believed to reduce central nervous system immune-mediated inflammatory processes, which translate into demonstrable improvement in clinical and radiologic outcomes. However, some DMTs are associated with long-lasting effects on the immune system and/or serious adverse events, both of which may complicate the use of subsequent therapies. When customizing a treatment program, a benefit–risk assessment must consider multiple factors, including the efficacy of the DMT to reduce disease activity, the short- and long-term safety and immunologic profiles of each DMT, the criteria used to define switching treatment, and the risk tolerance of each patient. A comprehensive benefit–risk assessment can only be achieved by evaluating the immunologic, safety, and efficacy data for DMTs in the controlled clinical trial environment and the postmarketing clinical practice setting. This review is intended to help neurologists make informed decisions when treating RMS by summarizing the known data for each DMT and raising awareness of the multiple considerations involved in treating people with RMS throughout the entire course of their disease.
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Metadata
Title
The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations
Authors
Gabriel Pardo
David E. Jones
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 12/2017
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-017-8594-9

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