Consensus recommendations for the diagnosis and treatment of multiple sclerosis: 2019 revisions to the MENACTRIMS guidelines

Yamout, Bassem; Sahraian, Mohammad Ali; Bohlega, Saeed; Aljumah, Mohammed; Goueider, R.; Dahdaleh, Maurice; Inshasi, Jihad; Hashem, Saher; Alsharoqi, I.; Khoury, Samia J.; Alkhawajah, Mona; Koussa, Salam; Khaburi, J. Al; Al-Mahdawi, Akram M.; Alsaadi, Taoufik; Slassi, E.; Daodi, S; Zakaria, Magd; Alroughani, Raed

doi:10.1016/j.msard.2019.101459

Cited by 77 publications

(57 citation statements)

References 162 publications

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“…In addition, the current guideline for the wider region of the Middle East and North Africa (MENACTRIMS) supports the use of off-label therapies under some conditions, e.g. to use a DMD without a specific indication for MS in place of a licensed drug of a similar mechanism [5], For clarity, we have restricted our discussions to DMDs with a specific indication for use in MS.…”

Section: Prescribing Dmds In the Gulf Regionmentioning

confidence: 99%

“…The efficacy, tolerability, and safety of DMDs have been reviewed extensively elsewhere [5,12]. For the purposes of this article, discussion of the properties of individual DMDs will be brief, and Table 1 provides a brief overview of their administration, efficacy, and safety [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Section: Overview Of Dmdsmentioning

confidence: 99%

“…DMDs approved for the management of relapsing-remitting MS (RRMS) are often classified into broad groups. 'First-line' or 'platform' agents usually refer to interferons, glatiramer acetate, and teriflunomide, while 'highefficacy' agents usually include fingolimod, alemtuzumab, natalizumab, ocrelizumab, and cladribine tablets [5,12]. Dimethyl fumarate may be intermediate between these categories, as there is some evidence that the efficacy of this agent is similar to that of fingolimod [33,34].…”

Section: Overview Of Dmdsmentioning

confidence: 99%

“…It is important that appropriate local guidance is available for physicians to manage MS, but until recently the region had been largely overlooked by guideline writers. This was rectified to some extent by the publication of comprehensive guidance from the Middle East and North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS), updated in 2019 [5].…”

Section: Introductionmentioning

confidence: 99%

“…Guidance specifically for Gulf countries is lacking, however, and the treatment landscape has changed in recent years. For example, new treatments have become available, and access to these treatments has improved [5][6][7][8]. We know more about the potential safety profiles of disease-modifying drugs (DMDs), leading to a better understanding of the risks of highly active DMDs for MS, including mitigating the risk of progressive multifocal leukoencephalopathy (PML) with natalizumab and other MS treatments, and a reassessment of the role of alemtuzumab in MS therapy [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Expert consensus from the Arabian Gulf on selecting disease-modifying treatment for people with multiple sclerosis according to disease activity

Alroughani

Inshasi

Al‐Asmi

et al. 2020

Postgraduate Medicine

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Recent research has expanded our understanding of the natural history and clinical course of multiple sclerosis (MS) in the Arabian Gulf region. In addition, the number of available therapies for MS has increased greatly in recent years, which complicates considerably the design of therapeutic regimens. We, an expert group of physicians practising in Arabian Gulf countries, present pragmatic consensus recommendations for the use of disease-modifying therapy, according to the level of MS disease activity, according to objective criteria, and prior treatment (if any) received by a given patient.

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Section: Prescribing Dmds In the Gulf Regionmentioning

confidence: 99%

Section: Overview Of Dmdsmentioning

confidence: 99%

Section: Overview Of Dmdsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Expert consensus from the Arabian Gulf on selecting disease-modifying treatment for people with multiple sclerosis according to disease activity

Alroughani

Inshasi

Al‐Asmi

et al. 2020

Postgraduate Medicine

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Initiation Patterns of Disease-Modifying Therapies for Multiple Sclerosis Among US Adults and Children, 2001 Through 2020

et al. 2023

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ImportanceMany disease-modifying therapies (DMTs) have been approved for multiple sclerosis (MS) in the past 2 decades. Research evaluating how these approvals have changed real-world prescribing patterns is scarce.ObjectiveTo evaluate patterns in DMT initiations between 2001 and 2020 among commercially insured US adults and children with MS.Design, Setting, and ParticipantsThis serial cross-sectional study was conducted from 2001 through 2020 (mean patient enrollment duration, 4.8 years) and used US commercial claims data (MarketScan). Analysis took place between January 2022 and March 2023. Of 287 084 patients with MS identified, 113 583 patients (113 095 adults and 488 children) with MS newly initiated at least 1 DMT.ExposureNew initiation episode of a DMT, defined as no claim for the same DMT in the previous year.Main Outcome MeasureThe proportion of total DMT initiations per year attributable to each DMT. Trends in initiations were evaluated annually.ResultsThe study team identified 153 846 DMT initiation episodes among adults (median age, 46 [IQR, 38-53) years]; 86 133 female [76.2%]) and 583 among children (median age, 16 (IQR, 14-17) years; 346 female [70.9%]). Among adults, use of platform injectables showed an absolute decline of 73.8% over the study period, driven by a 61.2% reduction in interferon β initiations (P &lt; .001 for trend). In contrast, the 2010 introduction of oral DMTs led to a rise in their use from 1.1% (2010) to 62.3% (2020) of all DMT initiations (P = .002 for trend). Infusion therapy initiations remained relatively low, accounting for 3.2% of all initiations since their introduction in 2004 but increased modestly annually after ocrelizumab was introduced (2017), reaching 8.2% of all initiations in 2020 (P &lt; .001 for trend). Children showed similar initiation patterns, except for preferred oral therapy. Between 2019 and 2020, dimethyl fumarate was the most commonly initiated DMT in adults (23.3% to 27.2% of all initiations), while in children fingolimod was the most commonly initiated (34.8% to 68.8%).Conclusions and RelevanceCurrent MS treatment guidelines emphasize shared decision-making between patients and clinicians to balance treatment efficacy, safety, cost, and convenience. This study found that oral DMTs were the predominant DMT type initiated by 2020. The cause of this shift cannot be determined from this study, but may reflect several factors, including convenience of administration, direct-to-consumer advertising, or insurance restrictions.

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Rituximab for people with multiple sclerosis

Filippini

Kruja

et al. 2021

Cochrane Database of Systematic Reviews

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The main objective is to assess the benefits and harms of rituximab compared to placebo or another DMT for people with multiple sclerosis. Specific comparisons include:• rituximab compared with placebo or other DMTs as first choice treatment for relapsing forms of MS;• rituximab when switching from another DMT compared with placebo or other DMTs for relapsing forms of MS;• rituximab compared with placebo or other DMTs as first choice treatment for progressive forms of MS; and • rituximab when switching from another DMT compared with placebo or other DMTs for progressive forms of MS.

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Consensus recommendations for the diagnosis and treatment of multiple sclerosis: 2019 revisions to the MENACTRIMS guidelines

Cited by 77 publications

References 162 publications

Expert consensus from the Arabian Gulf on selecting disease-modifying treatment for people with multiple sclerosis according to disease activity

Expert consensus from the Arabian Gulf on selecting disease-modifying treatment for people with multiple sclerosis according to disease activity

Initiation Patterns of Disease-Modifying Therapies for Multiple Sclerosis Among US Adults and Children, 2001 Through 2020

Rituximab for people with multiple sclerosis

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