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    Area of Science:

    • Neurology
    • Immunology
    • Pharmacology

    Background:

    • The landscape of multiple sclerosis (MS) treatment has rapidly evolved.
    • Nineteen US Food and Drug Administration (FDA)-approved immunotherapies were available by 2021.
    • The COVID-19 pandemic highlighted concerns about vaccine efficacy in patients on immunosuppressive therapies.

    Purpose of the Study:

    • To outline a framework for developing treatment strategies for relapsing MS.
    • To review mechanisms of action, efficacy, and safety of various therapeutic classes.
    • To address considerations for switching or discontinuing therapies and vaccine efficacy.

    Main Methods:

    • Comprehensive literature review of immunotherapies for relapsing MS.
    • Analysis of treatment strategies, including medication selection and discontinuation.
    • Evaluation of safety, efficacy, and pharmacovigilance data for approved agents.

    Main Results:

    • All reviewed immunotherapies effectively reduce relapse frequency in MS.
    • Most therapies also demonstrate a reduction in the accumulation of neurologic disability.
    • Concerns regarding reduced vaccine efficacy in patients on immune-suppressing therapies are noted.

    Conclusions:

    • A strategic approach to MS treatment, considering individual patient needs and medication profiles, is crucial.
    • Pharmacovigilance is essential for the safe management of immunomodulatory and immunosuppressive agents.
    • Understanding the impact of MS therapies on vaccine efficacy is vital for patient care.