Administration and Monitoring Burden of High-Efficacy Disease-Modifying Therapies for Multiple Sclerosis: A Delphi Consensus of Clinical Experts from Saudi Arabia
Neurology and Therapy,
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 4, 2025
The
emergence
of
high-efficacy
disease-modifying
therapies
(HE
DMT)
for
multiple
sclerosis
(MS)
may
pose
challenges
to
the
administration
and
monitoring
burden
therapies.
This
article
presents
results
Delphi
consensus
method
generate
insights
from
experts
on
HE
DMT
in
Saudi
Arabia
with
a
special
focus
cladribine.
Between
January
March
2023,
two-round
modified
was
used
establish
regarding
DMTs
MS.
Through
questionnaire,
advisors
evaluated
17
properties
six
individual
basis
their
clinical
experience.
Advisors
were
required
rank
each
property
scale
1–5,
1
being
lowest
5
highest
burden.
Experts
ranked
cladribine
as
having
burden,
followed
by
ofatumumab
ocrelizumab.
Natalizumab
fingolimod
fourth,
alemtuzumab
had
During
first
round,
agreed
scores
properties,
except
hospital
visit
time
facility
use
during
ofatumumab,
route
fingolimod,
specific
side
effects
frequency
lab
tests
at
follow-up,
washout
period
natalizumab.
second
there
agreement
all
properties.
In
absence
alternative
scientific
data,
recommendations
provide
useful
into
MS
Arabia.
Язык: Английский
Real World Experience with Cladribine Tablets for Multiple Sclerosis at Four Academic Multiple Sclerosis Centers
Devon Conway,
Jacqueline A. Nicholas,
Nicolas R. Thompson
и другие.
Multiple Sclerosis and Related Disorders,
Год журнала:
2025,
Номер
94, С. 106272 - 106272
Опубликована: Янв. 14, 2025
Язык: Английский
The Italian Multiple Sclerosis Register Experience With Cladribine
Neurology Neuroimmunology & Neuroinflammation,
Год журнала:
2025,
Номер
12(4)
Опубликована: Июнь 5, 2025
Cladribine
is
an
immune
reconstitution
therapy
approved
for
relapsing
multiple
sclerosis
(RMS).
This
multicentric
retrospective
study
of
the
Italian
Multiple
Sclerosis
Register
(RISM)
aimed
to
assess
effect
cladribine
on
annualized
relapse
rate
(ARR)
and
progression
independent
activity
(PIRA)
phenomena,
also
evaluating
strategies
disease-modifying
treatment
(DMT)
continuation
after
termination.
Patients
with
RMS
treated
at
least
one
cycle
recorded
in
RISM
2018
were
retrospectively
included
analysis.
previously
other
DMTs
stratified
into
moderately
highly
effective
DMTs.
Adjusted
ARR
PIRA
events
calculated
overall
cohort
by
age
start
(<50
vs
≥
50
years)
previous
DMT.
ARRs
compared
between
groups
using
negative
binomial
models.
was
analyzed
Ghosh-Lin
Cox-type
regression
marginal
mean.
prescribed
cycles
analyzed.
A
total
2,329
patients
identified
RISM,
a
median
(IQR)
36.5
(29.2-45.2)
years
start.
1,488
(63.9%)
received
2
courses
cladribine.
decreased
(p
<
0.0001)
from
0.96
(95%
CI
0.91-1.02)
preceding
0.09
(0.08-0.11)
during
cohort.
One
hundred
thirty-three
reported
noncladribine
period
54
(HR
0.711,
95%
0.531-0.952,
p
=
0.0219)
entire
All
analyses
confirmed
significant
reduction
suppression
activity.
After
cladribine,
most
ocrelizumab,
ofatumumab,
natalizumab.
Eight
re-treated
additional
identified.
For
RMS,
both
naïve
switchers,
as
well
younger
older
patients,
reducing
relapses
PIRA.
Different
therapeutic
are
currently
reported.
provides
Class
IV
evidence
that
sclerosis,
associated
events.
Язык: Английский
Holistic, Long-Term Management of People with Relapsing Multiple Sclerosis with Cladribine Tablets: Expert Opinion from France
Neurology and Therapy,
Год журнала:
2024,
Номер
13(3), С. 503 - 518
Опубликована: Март 15, 2024
Cladribine
tablets
(CladT)
has
been
available
for
therapeutic
use
in
France
since
March
2021
the
management
of
highly
active
relapsing
multiple
sclerosis
(RMS).
This
high-efficacy
disease-modifying
therapy
(DMT)
acts
as
an
immune
reconstitution
therapy.
In
contrast
to
most
DMTs,
which
act
via
continuous
immunosuppression,
two
short
courses
oral
treatment
with
CladT
at
beginning
years
1
and
2
provide
long-term
control
MS
disease
activity
responders
treatment,
without
need
any
further
pharmacological
several
years.
Although
labelling
does
not
guidance
beyond
initial
courses,
real-world
data
on
from
registries
previous
clinical
trial
participants
patients
treated
routine
practice
indicate
that
is
controlled
a
period
this
time
substantial
proportion
patients.
Moreover,
experience
provided
useful
information
how
initiate
manage
CladT.
article
we,
group
expert
neurologists
France,
recommendations
initiation
DMT-naïve
patients,
switch
existing
DMTs
continuing
activity,
during
first
finally,
or
3,
4
after
initiating
We
believe
optimisation
its
will
maximise
benefits
especially
early
course
when
suppression
focal
inflammation
CNS
priority
limit
progression.
Язык: Английский
Terapias Emergentes na Esclerose Múltipla: Perspectivas e Futuro
Maria Eduarda Andrade Trajano dos Santos,
Gabriel Silva Fideli,
Walter Rodrigues Júnior
и другие.
Brazilian Journal of Implantology and Health Sciences,
Год журнала:
2023,
Номер
5(5), С. 4828 - 4841
Опубликована: Дек. 7, 2023
Esta
pesquisa
investiga
a
progressão
das
terapias
emergentes
no
âmbito
do
tratamento
da
esclerose
múltipla
(EM),
enfatizando
importância
dessas
abordagens
manejo
desta
intricada
condição
neurológica.
As
desempenham
uma
função
crucial
na
busca
por
alternativas
mais
eficazes
e
focalizadas,
ultrapassando
as
convencionais
de
modulação
imunológica
controle
sintomático.
A
análise
integral
destas
opções
objetiva
proporcionar
aos
profissionais
saúde
compreensão
aprofundada
estratégias
recentes
inovadoras,
levando
em
consideração
fatores
como
patologia
qualidade
vida
dos
pacientes.
determinação
EM
é
multifacetada,
influenciada
variáveis
o
perfil
genético
paciente,
estágio
doença
resposta
tratamentos
anteriores.
Nesse
contexto,
avaliação
comparativa
distintas
abordagens,
tais
imunoterapias
avançadas,
celulares
intervenções
genéticas,
torna-se
imperativa
para
garantir
eficácia
minimizar
possíveis
efeitos
adversos.
Ademais,
com
representa
um
desafio
complexo
que
exige
abordagem
integrada.
explora
diversas
modalidades
terapêuticas,
desde
farmacológicas
até
métodos
não
farmacológicos,
intuito
fornecer
discernimentos
valiosos
otimizar
gerenciamento
aprimorar
pacientes
pós-tratamento.
complexidades
sutilezas
assegurar
cuidado
abrangente
personalizado
EM,
ressaltando
holística
gestão
dessa
neurodegenerativa.
Por
fim,
este
artigo
almeja
consolidar
informações
atualizadas
sobre
múltipla,
fornecendo
crítica
literatura
científica
disponível.
O
propósito
contribuir
contínuo
desenvolvimento
práticas
clínicas
nessa
área,
promovendo
procedimentos
aprimorando
os
enfrentam
esta
desafiadora