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Switching therapies in multiple sclerosis.

Patricia K Coyle1

  • 1Department of Neurology, Stony Brook University Medical Center, HSC T12-020, Stony Brook, NY 11794-8121, USA. patricia.coyle@stonybrookmedicine.edu

CNS Drugs
|March 20, 2013
PubMed
Summary
This summary is machine-generated.

Multiple sclerosis patients often switch disease-modifying therapies due to side effects or disease activity. This overview proposes principles and suggestions for switching multiple sclerosis (MS) therapies when current treatments are ineffective or intolerable.

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) has nine approved disease-modifying therapies (DMTs) with six distinct mechanisms of action.
  • Current MS therapies have side effects and are not cures, necessitating treatment adjustments.
  • Breakthrough disease activity or intolerance often leads to drug switching in relapsing MS.

Purpose of the Study:

  • To address the lack of universal guidelines for switching disease-modifying therapies in multiple sclerosis.
  • To propose evidence-based principles and practical suggestions for managing MS therapy switches.

Main Methods:

  • Literature review of current multiple sclerosis treatment guidelines and clinical practices.
  • Analysis of drug mechanisms, side effect profiles, and efficacy data for approved MS therapies.
  • Synthesis of information to formulate practical switch principles.

Main Results:

  • Identified common scenarios prompting therapy switches, including intolerance and breakthrough disease.
  • Highlighted the absence of standardized protocols for switching MS DMTs.
  • Developed a framework for considering factors influencing the decision to switch MS therapies.

Conclusions:

  • Switching disease-modifying therapies is a common but complex aspect of multiple sclerosis management.
  • Standardized guidelines are needed to optimize the process of switching MS therapies.
  • Proposed principles aim to guide clinicians in making informed decisions for patients requiring a change in MS treatment.