High-efficacy Therapies for relapsing-remitting Multiple Sclerosis: Implications for adherence. an Expert Opinion From the United Arab Emirates

Abstract

The number of disease-modifying treatments (DMDs) for relapsing-remitting multiple sclerosis has increased. DMDs differ not only in their efficacy and safety/tolerability, but also in the treatment burden of, associated with their initiation, route/frequency of administration, maintenance treatment and monitoring. High-efficacy DMDs bring the prospect of improved suppression of relapses and progression of disability, but may have serious safety issues, and burdensome long-term monitoring. Studies of patient preferences in this area have focused on side effects, efficacy and route of administration. Adherence to DMDs is often suboptimal in relapsing-remitting multiple sclerosis and there is a need to understand more about how the complex therapeutic and administration profiles of newer DMDs interact with these barriers to support optimal adherence to therapy.

Position of Cladribine Tablets in the Management of Relapsing-Remitting Multiple Sclerosis: An Expert Narrative Review From the United Arab Emirates

“…The IRT approach renders these issues moot [18,36,79,80]: for example, for a patient who responds to treatment with cladribine tablets there is no need for regular intakes of treatment or for continued monitoring beyond 6 months of the last dose (or the recovery of lymphocytes, if this takes longer). This expert group supported this principle, as their support for the use of cladribine tablets in CLARITY-like patients (one relapse in the previous year or 2 relapses in the previous 2 years) was stronger if the patient's lifestyle preferences mitigated against the use of continuous treatment or if the patient was likely to be non-compliant with this approach.…”

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“…Outra variável que possibilitou a redução de custos foi a via de administração oral da cladribina (Merck S/A, 2021). Outras estratégias, administradas por via injetável, necessitam de infusão em ambiente hospitalar, eventualmente com a necessidade de administração de outras medicações antes ou durante a infusão, além de monitoramento após a infusão para avaliar a ocorrência de reações de hipersensibilidade (Biogen Brasil Produtos Farmacêuticos Ltda., 2021;Inshasi et al, 2020). Por fim, é estimado que cerca de 95% dos pacientes com EM preferem o uso de terapias orais, dada a facilidade de uso e por sua administração não invasiva (The National Institute for Health and Care Excellence, 2017).…”

Welcome to the 11th Volume of Neurodegenerative Disease Management

“…An increase in the number of high-efficacy disease-modifying drugs has both improved and complicated the management of relapsing-remitting MS, requiring physicians to balance the efficacy, tolerability, safety and monitoring requirements of these treatments with the clinical characteristics of their patient's MS and the patient's own lifestyle needs and preferences. In their review article, Inshasi et al discuss the available therapies to highlight practical issues relevant to the delivery of effective MS care in a challenging healthcare environment [6].…”