Деэскалация и прекращение лечения различных видов склероза.
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История · было → стало
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Androdias Géraldine, Lünemann Jan D, Maillart Elisabeth, Amato Maria Pia, Audoin Bertrand, Bruijstens Arlette L, Bsteh Gabriel, Butzkueven Helmut, Ciccarelli Olga, Cobo-Calvo Alvaro, Derfuss Tobias, Di Pauli Franziska, Edan Gilles, Enzinger Christian, Geraldes Ruth, Granziera Cristina, Hacohen Yael, Hartung Hans-Peter, Hynes Sinéad, Inglese Matilde, Kappos Ludwig, Kuusisto Hanna, Langer-Gould Annette, Magyari Melinda, Marignier Romain, Montalban Xavier, Mycko Marcin P, Nourbakhsh Bardia, Oh Jiwon, Oreja-Guevara Celia, Piehl Fredrik, Prosperini Luca, Sastre-Garriga Jaume, Sellebjerg Finn, Selmaj Krzysztof, Siva Aksel, Tallantyre Emma, van Pesch Vincent, Vukusic Sandra, Weinstock-Guttman Bianca, Zipp Frauke, Tintoré Mar, Iacobaeus Ellen, Stankoff Bruno
Аннотация
Оригинал публикации
De-escalating and discontinuing disease-modifying therapies in multiple sclerosis.
The development of disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) has been highly successful in recent decades. It is now widely accepted that early initiation of DMTs after disease onset is associated with a better long-term prognosis. However, the question of when and how to de-escalate or discontinue DMTs remains open and critical. This topic was discussed during an international focused workshop organized by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in 2023. The aim was to review the current evidence on the rationale for, and the potential pitfalls of, treatment de-escalation in MS. Several clinical scenarios emerged, mainly driven by a change in the benefit-risk ratio of DMTs over the course of the disease and with ageing. The workshop also addressed the issue of de-escalation by the type of DMT used and in specific situations, including pregnancy and paediatric onset MS. Finally, we provide practical guidelines for selecting appropriate patients, defining de-escalation and monitoring modalities and outlining unmet needs in this field.