High-Efficacy Therapies for Treatment-Naïve Individuals with Relapsing-Remitting Multiple Sclerosis.
High-Efficacy Therapies for Treatment-Naïve Individuals with Relapsing-Remitting Multiple Sclerosis.
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有> 18种不同的疾病修饰疗法（DMT）选择，涵盖美国食品和药物管理局目前批准用于治疗复发缓解型多发性硬化症（RRMS）的10种作用机制。考虑到多种可用的治疗方案，以及最近的国际共识指南提供了不同的建议，在临床实践中如何使用DMT存在广泛的异质性。为新诊断的MS患者选择DMT目前是MS护理中的一个重要辩论话题。历史上，DMT的递增方法用于新诊断的RRMS患者。然而，在这一人群中使用高效治疗（HIV-ET）早期治疗的临床益处的证据正在出现。在这篇综述中，我们提供了一个DMT选项和MS治疗策略的概述，并讨论了在MS的早期阶段的HESTERN（包括奥法木单抗，ocrelizumab，那他珠单抗，阿仑单抗和克拉屈滨）的临床获益，沿着与这些DMT相关的安全性问题。通过在病程早期最大限度地减少神经损伤的积累，早期使用HALGORY治疗可能会增强患者一生中的长期临床结局。在线版本包含补充材料，可通过10.1007/s40263-022-00965-7获得。疾病修饰疗法（DMT）可以通过改变多发性硬化症（MS）患者随时间发展的方式来帮助他们。一些MS患者在症状恶化时会复发，然后在MS缓解时恢复。这被称为复发缓解型MS（RRMS）。DMT可以减少复发的数量和严重程度。它们还可以延缓复发引起的神经损伤。一系列DMT被批准用于治疗RRMS患者。这些治疗方法以不同的方式起作用，国际治疗指南对临床使用DMT的建议也各不相同。为新诊断的RRMS患者选择DMT仍然是一个讨论的话题。以前，RRMS患者只有在第一次治疗无效的情况下才接受更有效的高效治疗（HRM）。受阻剂包括奥法木单抗、ocrelizumab、那他珠单抗、阿仑单抗和克拉屈滨。最近，在早期阶段使用HALTORY已经显示出有希望的结果。在这篇综述文章中，我们提供了一个概述的临床策略和DMT的选择，可用于MS的人。此外，我们讨论了使用Hastin的好处，新诊断的MS的人，并考虑与DMT的安全性问题。我们总结说，在MS的早期阶段，使用Hestival来减少神经损伤的积累可能会改善一个人一生中的长期临床结果。在线版本包含补充材料，可通过10.1007/s40263-022-00965-7获得。
There are > 18 distinct disease-modifying therapy (DMT) options covering 10 mechanisms of action currently approved by the US Food and Drug Administration for the treatment of relapsing–remitting multiple sclerosis (RRMS). Given the multitude of available treatment options, and recent international consensus guidelines offering differing recommendations, there is broad heterogeneity in how the DMTs are used in clinical practice. Choosing a DMT for newly diagnosed patients with MS is currently a topic of significant debate in MS care. Historically, an escalation approach to DMT was used for newly diagnosed patients with RRMS. However, the evidence for clinical benefits of early treatment with high-efficacy therapies (HETs) in this population is emerging. In this review, we provide an overview of the DMT options and MS treatment strategies, and discuss the clinical benefits of HETs (including ofatumumab, ocrelizumab, natalizumab, alemtuzumab, and cladribine) in the early stages of MS, along with safety concerns associated with these DMTs. By minimizing the accumulation of neurological damage early in the disease course, early treatment with HETs may enhance long-term clinical outcomes over the lifetime of the patient. The online version contains supplementary material available at 10.1007/s40263-022-00965-7. Disease-modifying therapies (DMTs) can help people with multiple sclerosis (MS) by changing the way that their MS develops over time. Some people with MS have relapses when their symptoms get worse, followed by recovery when their MS is remitting. This is called relapsing–remitting MS (RRMS). DMTs can reduce both the number and the severity of relapses. They can also delay the nerve damage that relapses cause. A range of DMTs are approved for treating people with RRMS. These treatments work in different ways, and international treatment guidelines vary on their recommendations for using DMTs in the clinic. Selecting DMTs for people with newly diagnosed RRMS is still a topic of discussion. Previously, people with RRMS only received the more effective high-efficacy therapies (HETs) if their first treatment was not effective. HETs include ofatumumab, ocrelizumab, natalizumab, alemtuzumab, and cladribine. Recently, using HETs at an earlier stage has shown promising results. In this review article, we provide an overview of the clinical strategies and the DMT options that are available for people with MS. Additionally, we discuss the benefits of using HETs for people with newly diagnosed MS and consider the safety issues related to DMTs. We summarize that using HETs to reduce the buildup of nerve damage during the early stages of MS may lead to improved long-term clinical outcomes over a person’s lifetime. The online version contains supplementary material available at 10.1007/s40263-022-00965-7.
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影响因子：
29
作者：
Bjornevik, Kjetil;Munger, Kassandra L.;Ascherio, Alberto
通讯作者：
Ascherio, Alberto
影响因子：
120.7
作者：
Brown, J. William L.;Coles, Alasdair;Zwanikken, Cees
通讯作者：
Zwanikken, Cees
影响因子：
5.9
作者：
Coles AJ;Arnold DL;Bass AD;Boster AL;Compston DAS;Fernández Ó;Havrdová EK;Nakamura K;Traboulsee A;Ziemssen T;Jacobs A;Margolin DH;Huang X;Daizadeh N;Chirieac MC;Selmaj KW
通讯作者：
Selmaj KW
影响因子：
9.9
作者：
Coles AJ;Cohen JA;Fox EJ;Giovannoni G;Hartung HP;Havrdova E;Schippling S;Selmaj KW;Traboulsee A;Compston DAS;Margolin DH;Thangavelu K;Chirieac MC;Jody D;Xenopoulos P;Hogan RJ;Panzara MA;Arnold DL;CARE-MS II and CAMMS03409 Investigators
通讯作者：
CARE-MS II and CAMMS03409 Investigators
影响因子：
168.9
作者：
Coles, Alasdair J.;Twyman, Cary L.;Compston, D. Alastair S.
通讯作者：
Compston, D. Alastair S.