Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective - part 3: treatment practicalities and recommendations

Broadley, Simon A., Barnett, Michael H., Boggild, Mike, Brew, Bruce J., Butzkueven, Helmut, Heard, Robert, Hodgkinson, Suzanne, Kermode, Allan G., Lechner-Scott, Jeannette, Macdonell, Richard A. L., Marriott, Mark, Mason, Deborah F., Parratt, John, Reddel, Stephen W., Shaw, Cameron P., Slee, Mark, Spies, Judith, Taylor, Bruce V., Carroll, William M., Kilpatrick, Trevor J., King, John, McCombe, Pamela A., Pollard, John D. and Willoughby, Ernest (2014) Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective - part 3: treatment practicalities and recommendations. Journal of Clinical Neuroscience, 21 11: 1857-1865. doi:10.1016/j.jocn.2014.01.017


Author Broadley, Simon A.
Barnett, Michael H.
Boggild, Mike
Brew, Bruce J.
Butzkueven, Helmut
Heard, Robert
Hodgkinson, Suzanne
Kermode, Allan G.
Lechner-Scott, Jeannette
Macdonell, Richard A. L.
Marriott, Mark
Mason, Deborah F.
Parratt, John
Reddel, Stephen W.
Shaw, Cameron P.
Slee, Mark
Spies, Judith
Taylor, Bruce V.
Carroll, William M.
Kilpatrick, Trevor J.
King, John
McCombe, Pamela A.
Pollard, John D.
Willoughby, Ernest
Title Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective - part 3: treatment practicalities and recommendations
Journal name Journal of Clinical Neuroscience   Check publisher's open access policy
ISSN 0967-5868
Publication date 2014-11
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jocn.2014.01.017
Open Access Status
Volume 21
Issue 11
Start page 1857
End page 1865
Total pages 9
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Collection year 2015
Language eng
Abstract In this third and final part of our review of multiple sclerosis (MS) treatment we look at the practical day-to-day management issues that are likely to influence individual treatment decisions. Whilst efficacy is clearly of considerable importance, tolerability and the potential for adverse effects often play a significant role in informing individual patient decisions. Here we review the issues surrounding switching between therapies, and the evidence to assist guiding the choice of therapy to change to and when to change. We review the current level of evidence with regards to the management of women in their child-bearing years with regards to recommendations about treatment during pregnancy and whilst breast feeding. We provide a summary of recommended pre- and post-treatment monitoring for the available therapies and review the evidence with regards to the value of testing for antibodies which are known to be neutralising for some therapies. We review the occurrence of adverse events, both the more common and troublesome effects and those that are less common but have potentially much more serious outcomes. Ways of mitigating these risks and managing the more troublesome adverse effects are also reviewed. Finally, we make specific recommendations with regards to the treatment of MS. It is an exciting time in the world of MS neurology and the prospects for further advances in coming years are high.
Keyword Evidence-based medicine
Guideline
Multiple sclerosis
Review
Treatment
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: UQ Centre for Clinical Research Publications
Official 2015 Collection
School of Medicine Publications
 
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