Consensus recommendations on multiple sclerosis management in Australia and New Zealand: part 2

IF 8.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL Medical Journal of Australia Pub Date : 2025-02-09 DOI:10.5694/mja2.52577

Jessica Shipley, James Beharry, Wei Yeh, Nabil Seery, Yi Chao Foong, Darshini Ayton, Pakeeran Siriratnam, Tracie Tan, Heidi Beadnall, Joshua Barton, Francesca Bridge, Robb Wesselingh, Lisa Taylor, Louise Rath, Jodi Haartsen, Mohammad Gadi, Cassie Nesbitt, Michael Zhong, Victoria Cushing, Fiona McKay, Julia Morahan, Benjamin Peter Trewin, Izanne Roos, Mark Marriott, Ai-Lan Nguyen, Emma Downey, Joanne Crosby, Julian Bosco, Jennifer Taylor, Lauren Giles, Nevin John, Ernest Butler, Anneke van der Walt, Helmut Butzkueven, Stefan Blum, Marion Simpson, Mark Slee, Sudarshini Ramanathan, Todd Hardy, Richard A L Macdonell, Katherine Buzzard, Deborah F Mason, Jeannette Lechner-Scott, Trevor J Kilpatrick, Tomas Kalincik, Bruce V Taylor, Simon A Broadley, Stephen Reddel, Douglas Johnson, Mastura Monif, the MS Interest Group, Australian and New Zealand Association of Neurologists

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Abstract

Introduction

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system with rapidly evolving treatment options and strategies. An iterative modified Delphi process was used to develop 80 consensus recommendations for the management of MS in Australia and New Zealand. Part 1 of these guidelines includes recommendations related to selection of initial disease-modifying therapy (DMT) for MS, assessments before commencing DMT, monitoring disease activity on DMT, switching DMT, and discontinuing DMT.

Main recommendations

This article, Part 2, covers recommendations related to risk mitigation during treatment with DMT, managing DMT in special situations (including pregnancy, postpartum, breastfeeding, active infection including COVID-19, and malignancy), general lifestyle measures for MS, acute MS relapses, and symptomatic treatments.

Changes in management as a result of the guidelines

Together with Part 1, this consensus statement provides practical guidance for clinicians involved in the care of adults (≥ 18 years old) with MS in Australia and New Zealand. A safe, effective and comprehensive approach to managing MS is crucial for improving long term outcomes and quality of life in individuals affected by MS.

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澳大利亚和新西兰多发性硬化症管理的共识建议：第2部分。

简介：多发性硬化症（MS）是一种中枢神经系统的慢性炎症和神经退行性疾病，治疗方案和策略正在迅速发展。采用迭代改进的德尔菲过程，为澳大利亚和新西兰的多发性硬化管理制定了80项共识建议。这些指南的第1部分包括与MS初始疾病改善治疗（DMT）的选择、开始DMT前的评估、监测DMT的疾病活动、切换DMT和停止DMT相关的建议。主要建议：本文第2部分涵盖了与DMT治疗期间风险降低、特殊情况下（包括妊娠、产后、母乳喂养、包括COVID-19在内的活动性感染和恶性肿瘤）管理、MS的一般生活方式措施、急性MS复发和对症治疗相关的建议。指南带来的管理变化：与第1部分一起，本共识声明为澳大利亚和新西兰参与成人（≥18岁）多发性硬化症护理的临床医生提供了实用指南。一种安全、有效和全面的治疗多发性硬化症的方法对于改善多发性硬化症患者的长期预后和生活质量至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Journal of Australia 医学-医学：内科

CiteScore

9.40

自引率

5.30%

发文量

410

审稿时长

3-8 weeks

期刊介绍： The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.