De-escalating and discontinuing disease-modifying therapies in multiple sclerosis - Summary - MDSpire

De-escalating and discontinuing disease-modifying therapies in multiple sclerosis

  • By

  • Géraldine Androdias

  • Jan D Lünemann

  • Elisabeth Maillart

  • Maria Pia Amato

  • Bertrand Audoin

  • Arlette L Bruijstens

  • Gabriel Bsteh

  • Helmut Butzkueven

  • Olga Ciccarelli

  • Alvaro Cobo-Calvo

  • Tobias Derfuss

  • Franziska Di Pauli

  • Gilles Edan

  • Christian Enzinger

  • Ruth Geraldes

  • Cristina Granziera

  • Yael Hacohen

  • Hans-Peter Hartung

  • Sinéad Hynes

  • Matilde Inglese

  • Ludwig Kappos

  • Hanna Kuusisto

  • Annette Langer-Gould

  • Melinda Magyari

  • Romain Marignier

  • Xavier Montalban

  • Marcin P Mycko

  • Bardia Nourbakhsh

  • Jiwon Oh

  • Celia Oreja-Guevara

  • Fredrik Piehl

  • Luca Prosperini

  • Jaume Sastre-Garriga

  • Finn Sellebjerg

  • Krzysztof Selmaj

  • Aksel Siva

  • Emma Tallantyre

  • Vincent van Pesch

  • Sandra Vukusic

  • Bianca Weinstock-Guttman

  • Frauke Zipp

  • Mar Tintoré

  • Ellen Iacobaeus

  • Bruno Stankoff

  • December 21, 2024

  • 0 min

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Objective:

To review the current evidence on the rationale for, and potential pitfalls of, treatment de-escalation in multiple sclerosis (MS), highlighting its clinical significance.

Key Findings:
  • De-escalation refers to switching to a less potent DMT or reducing dosage, with examples of specific DMTs.
  • Discontinuation of DMTs can be temporary or permanent, influenced by patient circumstances like pregnancy or adverse effects.
  • Age-related changes in immune function necessitate reassessment of DMTs, particularly in older patients.
Interpretation:

The evolving understanding of MS as a continuum necessitates tailored de-escalation strategies to optimize patient outcomes, considering individual patient histories.

Limitations:
  • Lack of consensus on de-escalation strategies, particularly regarding specific protocols.
  • Limited evidence compared to other fields like rheumatology and oncology, highlighting the need for more research.
Conclusion:

De-escalation and discontinuation of DMTs in MS require careful consideration of individual patient circumstances and ongoing monitoring, underscoring the need for further research.

Original Source(s)

De-escalating and discontinuing disease-modifying therapies in multiple sclerosis

  • by Géraldine Androdias, Jan D Lünemann, Elisabeth Maillart, Maria Pia Amato, Bertrand Audoin, Arlette L Bruijstens, Gabriel Bsteh, Helmut Butzkueven, Olga Ciccarelli, Alvaro Cobo-Calvo, Tobias Derfuss, Franziska Di Pauli, Gilles Edan, Christian Enzinger, Ruth Geraldes, Cristina Granziera, Yael Hacohen, Hans-Peter Hartung, Sinéad Hynes, Matilde Inglese, Ludwig Kappos, Hanna Kuusisto, Annette Langer-Gould, Melinda Magyari, Romain Marignier, Xavier Montalban, Marcin P Mycko, Bardia Nourbakhsh, Jiwon Oh, Celia Oreja-Guevara, Fredrik Piehl, Luca Prosperini, Jaume Sastre-Garriga, Finn Sellebjerg, Krzysztof Selmaj, Aksel Siva, Emma Tallantyre, Vincent van Pesch, Sandra Vukusic, Bianca Weinstock-Guttman, Frauke Zipp, Mar Tintoré, Ellen Iacobaeus, Bruno Stankoff

  • December 21, 2024

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