Scientific Publications Database

Article Title: Managing Multiple Sclerosis: Treatment Initiation, Modification, and Sequencing
Authors: Freedman, Mark S.; Selchen, Daniel; Prat, Alexandre; Giacomini, Paul S.
Journal: CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES Volume 45 Issue 5
Date of Publication:2018
Abstract:
Recent therapeutic advances in the management of multiple sclerosis (MS) have raised questions about the selection of appropriate patient candidates for various treatments and, if the plan is to move from one treatment to another, the appropriate sequencing of these therapies. The selected approach should provide optimal disease management without limiting future therapeutic options based on safety concerns, and recognize potential future treatments and the possibility of combination therapies. Additional challenges include incorporation of patient needs and preferences into the overall therapeutic approach, in order to ensure optimal outcomes in the short and long term. The objective of this manuscript is to provide an overview of what is currently known regarding the impact of various therapies for MS on future therapeutic choices (sequencing). In this context, we reviewed the available evidence in support of various treatments and, based on the presence of disease activity, suggested a scheme for switching or escalating therapy with the main focus on sequencing of therapeutic approaches.