Expert opinion: criteria for second-line ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Expert opinion: criteria for second-line treatment failure in patients with multiple sclerosis
Author(s) :
Vermersch, Patrick [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center - U 995 [LIRIC]
De Seze, Jerome [Auteur]
Clavelou, Pierre [Auteur]
Durand-Dubief, Francoise [Auteur]
Maillart, Elisabeth [Auteur]
Mekies, Claude [Auteur]
Moreau, Thibault [Auteur]
Papeix, Caroline [Auteur]
Tourbah, Ayman [Auteur]
Labauge, Pierre [Auteur]

Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center - U 995 [LIRIC]
De Seze, Jerome [Auteur]
Clavelou, Pierre [Auteur]
Durand-Dubief, Francoise [Auteur]
Maillart, Elisabeth [Auteur]
Mekies, Claude [Auteur]
Moreau, Thibault [Auteur]
Papeix, Caroline [Auteur]
Tourbah, Ayman [Auteur]
Labauge, Pierre [Auteur]
Journal title :
Multiple sclerosis and related disorders
Abbreviated title :
Mult Scler Relat Disord
Volume number :
36
Pages :
101406
Publication date :
2019-09-19
ISSN :
2211-0356
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
OBJECTIVE: In the management of multiple sclerosis (MS), defining criteria for identification of suboptimal therapy responses and switching treatment is essential to avoid worsening. Despite the lack of a standardised ...
Show more >OBJECTIVE: In the management of multiple sclerosis (MS), defining criteria for identification of suboptimal therapy responses and switching treatment is essential to avoid worsening. Despite the lack of a standardised definition, criteria for first-line treatment are well documented in the literature, based on clinical measures or magnetic resonance imaging (MRI) (gadolinium enhancing [Gd+ METHODS: Five regional boards involving 36 French MS experts were convened to discuss published literature regarding criteria for first- and second-line treatment failure, and to identify differences in local therapeutic practices. A national board of 11 experts was subsequently conducted to identify convergences and differences between regions, and to propose second-line criteria for the definition of therapeutic failure. RESULTS: Published information is lacking regarding second-line treatment failure criteria. In light of this, regional differences in current therapeutic practices are justifiable. Due to the risk-benefit ratio of these treatments and limited options for third-line treatments, the authors recommend a different therapeutic approach when assessing second-line treatment failure. The treatment switch for second-line treatment should be informed by confirmed disease progression, after 6 months, or combined clinical and MRI outcomes, but only after at least 1 year of treatment. CONCLUSIONS: Experts compared therapeutic attitudes and practices regarding second-line treatment failure between French regions. They identified convergences that were used to propose a national agreement on second-line treatment failure criteria, which should be evaluated in real-life prospective cohorts.Show less >
Show more >OBJECTIVE: In the management of multiple sclerosis (MS), defining criteria for identification of suboptimal therapy responses and switching treatment is essential to avoid worsening. Despite the lack of a standardised definition, criteria for first-line treatment are well documented in the literature, based on clinical measures or magnetic resonance imaging (MRI) (gadolinium enhancing [Gd+ METHODS: Five regional boards involving 36 French MS experts were convened to discuss published literature regarding criteria for first- and second-line treatment failure, and to identify differences in local therapeutic practices. A national board of 11 experts was subsequently conducted to identify convergences and differences between regions, and to propose second-line criteria for the definition of therapeutic failure. RESULTS: Published information is lacking regarding second-line treatment failure criteria. In light of this, regional differences in current therapeutic practices are justifiable. Due to the risk-benefit ratio of these treatments and limited options for third-line treatments, the authors recommend a different therapeutic approach when assessing second-line treatment failure. The treatment switch for second-line treatment should be informed by confirmed disease progression, after 6 months, or combined clinical and MRI outcomes, but only after at least 1 year of treatment. CONCLUSIONS: Experts compared therapeutic attitudes and practices regarding second-line treatment failure between French regions. They identified convergences that were used to propose a national agreement on second-line treatment failure criteria, which should be evaluated in real-life prospective cohorts.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Collections :
Research team(s) :
Neuroinflammation & Multiple Sclerosis (NEMESIS)
Submission date :
2021-06-23T11:43:49Z