PMID- 27891572
DCOM- 20180326
LR  - 20180326
IS  - 1600-0404 (Electronic)
IS  - 0001-6314 (Linking)
VI  - 136
IP  - 3
DP  - 2017 Sep
TI  - Safety concerns and risk management of multiple sclerosis therapies.
PG  - 168-186
LID - 10.1111/ane.12712 [doi]
AB  - Currently, more than ten drugs have been approved for treatment of
      relapsing-remitting multiple sclerosis (MS). Newer treatments may be more
      effective, but have less favorable safety record. Interferon-beta preparations
      and glatiramer acetate treatment require frequent subcutaneous or intramuscular
      injections and are only moderately effective, but have very rarely
      life-threatening adverse effects, whereas teriflunomide and dimethyl fumarate are
      administered orally and have equal or better efficacy, but have more potentially 
      severe adverse effects. The highly effective therapies fingolimod, natalizumab,
      daclizumab, and alemtuzumab have more serious adverse effects, some of which may 
      be life-threatening. The choice between drugs should be based on a benefit-risk
      evaluation and tailored to the individual patient's requirements in a dialogue
      between the patient and treating neurologist. Patients with average disease
      activity can choose between dimethyl fumarate and teriflunomide or the "old
      injectable." Patients with very active MS may choose a more effective drug as the
      initial treatment. In case of side effects on one drug, switch to another drug
      can be tried. Suboptimal effect of the first drug indicates escalation to a
      highly efficacious drug. A favorable benefit-risk balance can be maintained by
      appropriate patient selection and appropriate risk management on therapy. New
      treatments will within the coming 1-2 years change our current treatment
      algorithm for relapsing-remitting MS.
CI  - (c) 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Soelberg Sorensen, P
AU  - Soelberg Sorensen P
AD  - Department of Neurology, Danish Multiple Sclerosis Center, University of
      Copenhagen, Rigshospitalet, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20161127
PL  - Denmark
TA  - Acta Neurol Scand
JT  - Acta neurologica Scandinavica
JID - 0370336
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage/*adverse effects/therapeutic use
MH  - Multiple Sclerosis/*drug therapy
MH  - Risk Management
OT  - disease-modifying therapies
OT  - multiple sclerosis
OT  - relapsing-remitting multiple sclerosis
OT  - risk management
OT  - risk stratification
OT  - safety
OT  - treatment algorithm
EDAT- 2016/11/29 06:00
MHDA- 2018/03/27 06:00
CRDT- 2016/11/29 06:00
PHST- 2016/10/28 00:00 [accepted]
PHST- 2016/11/29 06:00 [pubmed]
PHST- 2018/03/27 06:00 [medline]
PHST- 2016/11/29 06:00 [entrez]
AID - 10.1111/ane.12712 [doi]
PST - ppublish
SO  - Acta Neurol Scand. 2017 Sep;136(3):168-186. doi: 10.1111/ane.12712. Epub 2016 Nov