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http://hdl.handle.net/1942/21708
Title: | Overview of the management of relapsing-remitting multiple sclerosis and practical recommendations | Authors: | Gallo, P. VAN WIJMEERSCH, Bart |
Issue Date: | 2015 | Publisher: | WILEY-BLACKWELL | Source: | EUROPEAN JOURNAL OF NEUROLOGY, 22 (S2), p. 14-21 | Abstract: | The initial phases of the clinical course of relapsing-remitting multiple sclerosis (MS) are characterized by a mainly inflammatory pathology which gives way to a largely neurodegenerative process as the disease evolves. As all currently available disease-modifying therapies aim to control inflammation, the window of opportunity for use is early in the disease course, specifically at the time of a clinically isolated syndrome suggestive of MS or in the early stages of relapsing-remitting MS. Approximately 30% of patients treated with first-line immunomodulators (interferon-beta or glatiramer acetate) show a suboptimal response during the first 1-2 years and require a switch to an alternative therapy. It is recommended not to wait too long to switch in order to prevent disease progression. Patients with a poor prognosis in particular may require a timely switch to a second-line agent. Regular monitoring of disease and therapy in patients with MS is essential. In the first year after diagnosis, clinical evaluations (neurological status, symptomatic assessment, patient well-being) should be performed at baseline, 3, 6 and 12 months, and then every 6 months thereafter. Brain magnetic resonance imaging (MRI) should be performed every 6 months in the first year of treatment, and at least once yearly thereafter. A spinal cord MRI should be performed once yearly in patients presenting spinal symptoms. | Notes: | [Gallo, P.] Univ Hosp Padova, Dept Neurosci, Multiple Sclerosis Ctr Veneto Reg CeSMuV, I-35128 Padua, Italy. [Van Wijmeersch, B.] Univ Hasselt, Rehabil & MS Ctr, Overpelt & Biomed Inst, Hasselt, Belgium. | Keywords: | disease-modifying therapy; escalation; glatiramer acetate; interferon-beta; multiple sclerosis; propensity score; relapsing-remitting; switching;disease-modifying therapy; escalation; glatiramer acetate; interferon-beta; multiple sclerosis; propensity score; relapsing remitting; switching | Document URI: | http://hdl.handle.net/1942/21708 | ISSN: | 1351-5101 | e-ISSN: | 1468-1331 | DOI: | 10.1111/ene.12799 | ISI #: | 000369952200003 | Rights: | © 2015 The Author(s) European Journal of Neurology © 2015 EAN | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2017 |
Appears in Collections: | Research publications |
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