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Neurology and Therapy
Published in: Neurology and Therapy 2/2023

Open Access 24-12-2022 | Multiple Sclerosis | REVIEW

The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus

Authors: Jerome De Sèze, Laurent Suchet, Claude Mekies, Eric Manchon, Pierre Labauge, Anne-Marie Guennoc, Gilles Defer, Pierre Clavelou, Giovanni Castelnovo, Bertrand Bourre, Caroline Bensa-Koscher, Abdullatif Al Khedr, Julie Le Mao, Lauriane Villemur, Stephane Bouée, Laura Luciani, Patrick Vermersch

Published in: Neurology and Therapy | Issue 2/2023

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Abstract

The treatment strategy in relapsing multiple sclerosis (RMS) is a complex decision requiring individualization of treatment sequences to maximize clinical outcomes. Current local and international guidelines do not provide specific recommendation on the use of immune reconstitution therapy (IRT) as alternative to continuous immunosuppression in the management of RMS. The objective of the program was to provide consensus-based expert opinion on the optimal use of IRT in the management of RMS. A Delphi method was performed from May 2022 to July 2022. Nineteen clinical assertions were developed by a scientific committee and sent to 14 French clinical experts in MS alongside published literature. Two consecutive reproducible anonymous votes were conducted. Consensus on recommendations was achieved when more than 75% of the respondents agreed or disagreed with the clinical assertions. After the second round, consensus was achieved amongst 16 out of 19 propositions: 13 clinical assertions had a 100% consensus, 3 clinical assertions a consensus above 75% and 3 without consensus. Expert-agreed consensus is provided on topics related to the benefit of the early use of IRT from immunological and clinical perspectives, profiles of patients who may benefit most from the IRT strategy (e.g. patients with family planning, patient preference and lifestyle requirements). These French expert consensuses provide up-to-date relevant guidance on the use of IRT in clinical practice. The current program reflects status of knowledge in 2022 and should be updated in timely manner when further clinical data in IRT become available.
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Metadata
Title
The Place of Immune Reconstitution Therapy in the Management of Relapsing Multiple Sclerosis in France: An Expert Consensus
Authors
Jerome De Sèze
Laurent Suchet
Claude Mekies
Eric Manchon
Pierre Labauge
Anne-Marie Guennoc
Gilles Defer
Pierre Clavelou
Giovanni Castelnovo
Bertrand Bourre
Caroline Bensa-Koscher
Abdullatif Al Khedr
Julie Le Mao
Lauriane Villemur
Stephane Bouée
Laura Luciani
Patrick Vermersch
Publication date
24-12-2022
Publisher
Springer Healthcare
Published in
Neurology and Therapy / Issue 2/2023
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI
https://doi.org/10.1007/s40120-022-00430-z

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