De-escalation and Discontinuation of Disease-Modifying Therapies in Multiple Sclerosis.

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY Current Neurology and Neuroscience Reports Pub Date : 2024-09-01 Epub Date: 2024-07-12 DOI:10.1007/s11910-024-01355-w
Robert H Gross, John Corboy
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Abstract

Purpose of review: Long-term use of multiple sclerosis (MS) disease-modifying therapies (DMTs) is standard practice to prevent accumulation of disability. Immunosenescence and other age-related changes lead to an altered risk-benefit ratio for older patients on DMTs. This article reviews recent research on the topic of de-escalation and discontinuation of MS DMTs.

Recent findings: Observational and interventional studies have shed light on what happens to patients who de-escalate or discontinue DMTs and the factors, such as age, treatment type, and presence of recent disease activity, that influence outcomes. Though many questions remain, recent findings have been valuable for the development of an evidence-based approach to making de-escalation and discontinuation decisions in MS.

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多发性硬化症病情缓解疗法的降级和停用。
综述目的:长期使用多发性硬化症(MS)疾病修饰疗法(DMTs)是防止残疾累积的标准做法。免疫衰老和其他与年龄相关的变化导致老年患者使用 DMTs 的风险-获益比发生变化。本文回顾了有关多发性硬化症 DMTs 降级和停药的最新研究:观察性和干预性研究揭示了降级或停用 DMTs 的患者的情况,以及影响结果的因素,如年龄、治疗类型和近期疾病活动的存在。尽管仍存在许多问题,但最近的研究结果对于制定基于证据的方法来做出多发性硬化症的降级和停药决定非常有价值。
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来源期刊
CiteScore
9.20
自引率
0.00%
发文量
73
审稿时长
6-12 weeks
期刊介绍: Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.
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