Key result
High-efficacy disease-modifying therapies for relapsing multiple sclerosis require personalized selection based on clinical, radiological, and demographic aspects, guided by expert consensus.
Why the study?
Selecting the most appropriate disease-modifying therapy in RMS involves clinical, radiological, and demographic factors not always covered by regulatory criteria, creating difficulties regarding when high-efficacy therapies may offer greater benefit.
This narrative review provides pragmatic guidance on decision-making for the indication and management of high-efficacy disease-modifying therapies in adult patients with relapsing multiple sclerosis.
Relapsing multiple sclerosis (RMS) presents a highly variable clinical evolution among patients, and its management should be personalized. Although there is no cure at present, effective disease-modifying therapies (DMTs) are available. Selection of the most appropriate DMT for each patient is influenced by several clinical, radiological and demographic aspects as well as personal preferences that, at times, are not covered in the regulatory criteria. This may be a source of difficulty, especially in certain situations where so-called 'high-efficacy DMTs' (usually considered second-line) could be of greater benefit to the patient. In this narrative review, we discuss evidence and experience, and propose a pragmatic guidance on decision-making with respect to the indication and management of high-efficacy DMT in adult patients with RMS based on expert opinion.
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Meca-Lallana et al. (2021) conducted a review in Relapsing multiple sclerosis. High-efficacy disease-modifying therapies was evaluated. High-efficacy disease-modifying therapies for relapsing multiple sclerosis require personalized selection based on clinical, radiological, and demographic aspects, guided by expert consensus.
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