Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: An Australian and New Zealand perspective Part 3 Treatment practicalities and recommendations

Simon Broadley, Michael Barnett, Mike Boggild, Bruce Brew, H Butzkueven, Robert Heard, Suzanne Hodgkinson, Allan Kermode, Jeannette Lechner-Scott, Richard Macdonell, Mark Marriott, Deborah Mason, John Parratt, Stephen Reddel, Cameron Shaw, Mark Slee, Judith Spies, Bruce Taylor, William Carroll, Trevor KilpatrickJohn King, Pamela McCombe, John Pollard, Ernie Willoughby

    Research output: Contribution to journalArticle

    9 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)1857-1865
    Number of pages9
    JournalJournal of Clinical Neuroscience
    Volume21
    Issue number11
    DOIs
    Publication statusPublished - 2014

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    Broadley, S., Barnett, M., Boggild, M., Brew, B., Butzkueven, H., Heard, R., Hodgkinson, S., Kermode, A., Lechner-Scott, J., Macdonell, R., Marriott, M., Mason, D., Parratt, J., Reddel, S., Shaw, C., Slee, M., Spies, J., Taylor, B., Carroll, W., ... Willoughby, E. (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. https://doi.org/10.1016/j.jocn.2014.01.017