Newly approved agents for relapsing remitting multiple sclerosis: how real-world evidence compares with randomized clinical trials?

Comı, Gıancarlo; Costa, Gloria Dalla; Moiola, Lucia

doi:10.1080/14737175.2021.1829478

Cited by 9 publications

(15 citation statements)

References 151 publications

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“…Alemtuzumab is a humanized monoclonal antibody directed against lymphocytes surface protein CD52. It targets the surface of lymphocytes and monocytes determining a deep depletion of T and B lymphocytes 55 and leading to quantitative and qualitative changes in immune regulatory networks. These changes include suppression of memory B cells, inducing a relative increase in Treg and memory T-cell counts, and a potential shift from a pro- to anti-inflammatory environment (driven by differential reconstitution of T-cell subsets) 56 .…”

Section: Case Presentation and Therapy Discussion - When To Choose Hi...mentioning

confidence: 99%

How to choose initial treatment in multiple sclerosis patients: a case-based approach

Apóstolos

Boaventura

Mendes

et al. 2022

Arq. Neuro-Psiquiatr.

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Background: Immunotherapy dramatically changed the natural history of multiple sclerosis (MS), which was classically associated with severe disability. Treatment strategies advocate that early control of disease activity is crucial to avoid progressive disability, and the use of high efficacy drugs may be beneficial, but safety is a concern. Choosing the disease-modifying therapy is challenging in clinical practice and should be further discussed. Objective: To discuss the state of art of selecting the initial therapy for relapsing MS patients. Methods: We used a case-based approach followed by clinical discussion, exploring therapeutic options in different MS settings. Results: We presented clinical cases profile compatible with the use of MS therapies, classified into moderate and high efficacy. In the moderate efficacy group, we discussed interferons, glatiramer acetate, teriflunomide and dimethyl fumarate, while in the high efficacy group we discussed fingolimod, cladribine, natalizumab, ocrelizumab, alemtuzumab and ofatumumab. Conclusion: Advances in MS treatment are remarkable. Strong evidence supports the use of early high efficacy therapy. However, biomarkers, clinical and radiologic prognostic factors, as well as patients' individual issues, should be valued and considered for a personalized treatment decision.

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Section: Case Presentation and Therapy Discussion - When To Choose Hi...mentioning

confidence: 99%

How to choose initial treatment in multiple sclerosis patients: a case-based approach

Apóstolos

Boaventura

Mendes

et al. 2022

Arq. Neuro-Psiquiatr.

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“…There are nine classes of FDA-approved therapies for MS and three therapies for neuromyelitis optica spectrum disorder (NMOSD) [52] (Table 2). In general, prior to initiating MS therapies, COVID-19 testing is recommended to exclude asymptomatic infection that may become symptomatic upon initiation of immune therapies.…”

Section: Chronic Immunomodulation/immunosuppression and Covid-19mentioning

confidence: 99%

Potential Risks and Benefits of Multiple Sclerosis Immune Therapies in the COVID-19 Era: Clinical and Immunological Perspectives

Bhise

Dhib‐Jalbut

2021

Neurotherapeutics

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Coronavirus SARS-CoV2 has emerged as one of the greatest infectious disease health challenges in a century. Patients with multiple sclerosis (MS) have a particular vulnerability to infections through their use of immunosuppressive disease-modifying therapies (DMTs). Specific DMTs pose particular risk based on their mechanisms of action (MOA). As a result, patients require individualized approaches to starting new treatments and continuation of therapy. Additionally, vaccinations must be considered carefully, and individuals on long-term B cell–depleting therapies may have diminished immune responses to vaccination, based on preserved T cells and diminished but present antibody titers to influenza vaccines. We review the immunology behind these treatments and their impact on COVID-19, as well as the current recommendations for best practices for use of DMTs in patients with MS. Supplementary Information The online version contains supplementary material available at 10.1007/s13311-021-01008-7.

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“…Nettverksanalyser, slik som i Folkehelseinstituttets metodevurdering fra 2019, kan belyse dette (10), men bygger vanligvis på kortvarige studier av selekterte pasienter. Forløpsstudier basert på registre med lang oppfølgingstid gir klinisk relevant kunnskap om langsiktig behandlingseffekt og risiko (11).…”

Section: Behandlingseffekterunclassified

“…Nøkkelopplysninger om sykdomsbegrensende medikamenter mot attakkpreget multippel sklerose (RRMS) Både nettverksanalyser og forløpsstudier tilsier at natalizumab, alemtuzumab, okrelizumab og ofatumumab er blant de mest effektive medikamentene. Fase II-studier med hyppige MRundersøkelser viser også at effekten inntrer raskt (11). Kladribin, fingolimod og ozanimod er også mer effektive enn «førstelinjepreparatene» interferon beta, glatirameracetat og teriflunomid (11).…”

Section: Tabellunclassified

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Behandling som begrenser multippel sklerose

Holmøy¹,

Nygaard²,

Myhr³

et al. 2021

Tidsskriftet

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Trygve Holmøy er seksjonsoverlege for nevroimmunologi ved Akershus universitetssykehus og professor ved Universitetet i Oslo. Han er leder av referansegruppen for Nasjonalt kompetansesenter og har bidratt som fagekspert til Folkehelseinstituttets metodevurderinger for behandling av multippel sklerose. Han sitter også i styringsgruppen for ENSEMBLE-studien. Forfatter har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han har mottatt forelesningshonorar fra Merck, Biogen, Genzyme, Sanofi, Novartis og Roche, samt deltatt i behandlingsstudier organisert av Biogen, Merck og Roche. Han er med i MS-forbundets fagråd og Sykehusinnkjøps LIS-MS-spesialistgruppe. Han deltok i arbeidsgruppen som utarbeidet Nasjonal faglig retningslinje for diagnostikk og behandling av multippel sklerose. GRO OWREN NYGAARDGro Owren Nygaard er overlege ved nevrologisk avdeling ved Oslo Universitetssykehus og prosjektleder for den kliniske studien NOR-MS. Forfatter har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Hun er medlem av Oslo MS-forskningsgruppen og Sykehusinnkjøps LIS-MS-spesialistgruppe. KJELL-MORTEN MYHRKjell-Morten Myhr er professor ved Universitetet i Bergen og overlege ved Nevrologisk avdeling, Haukeland universitetssjukehus. Han er også senterleder for Neuro-SysMed, forskningssenter for klinisk behandling av alvorlige sykdommer i sentralnervesystemet, inkludert multippel sklerose. Forfatter har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Han har mottatt forelesningshonorar fra Biogen, Genzyme, Merck, Novartis og Roche og har deltatt i behandlingsstudier organisert av Biogen, Merck, Novartis og Roche. Myhr er med i MS-forbundets fagråd og Sykehusinnkjøps LIS-MS-spesialistgruppe. Myhr er også leder i arbeidsgruppen som utarbeidet Nasjonal faglig retningslinje for diagnostikk og behandling av multippel sklerose.

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Newly approved agents for relapsing remitting multiple sclerosis: how real-world evidence compares with randomized clinical trials?

Cited by 9 publications

References 151 publications

How to choose initial treatment in multiple sclerosis patients: a case-based approach

How to choose initial treatment in multiple sclerosis patients: a case-based approach

Potential Risks and Benefits of Multiple Sclerosis Immune Therapies in the COVID-19 Era: Clinical and Immunological Perspectives

Behandling som begrenser multippel sklerose

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