Book contents
- Multiple Sclerosis
- Multiple Sclerosis
- Copyright page
- Contents
- Preface
- Chapter 1 Autoimmune CNS Emergencies
- Chapter 2 Clinical Features of Multiple Sclerosis
- Chapter 3 Multiple Sclerosis Phenotypes
- Chapter 4 Diagnostic Evaluation
- Chapter 5 Differential Diagnosis
- Chapter 6 Neuroimaging in Multiple Sclerosis and Its Mimics
- Chapter 7 Disease-Modifying Therapies
- Chapter 8 Treatment Goals
- Chapter 9 Symptomatic Management
- Chapter 10 Reproductive Issues
- Chapter 11 Pediatric Multiple Sclerosis
- Chapter 12 Useful Websites
- Appendices
- Index
- Plate Section (PDF Only)
- References
Chapter 8 - Treatment Goals
Published online by Cambridge University Press: 10 February 2021
Book contents
- Multiple Sclerosis
- Multiple Sclerosis
- Copyright page
- Contents
- Preface
- Chapter 1 Autoimmune CNS Emergencies
- Chapter 2 Clinical Features of Multiple Sclerosis
- Chapter 3 Multiple Sclerosis Phenotypes
- Chapter 4 Diagnostic Evaluation
- Chapter 5 Differential Diagnosis
- Chapter 6 Neuroimaging in Multiple Sclerosis and Its Mimics
- Chapter 7 Disease-Modifying Therapies
- Chapter 8 Treatment Goals
- Chapter 9 Symptomatic Management
- Chapter 10 Reproductive Issues
- Chapter 11 Pediatric Multiple Sclerosis
- Chapter 12 Useful Websites
- Appendices
- Index
- Plate Section (PDF Only)
- References
Summary
The goals of treatment in multiple sclerosis (MS) have evolved greatly over the past few decades. The original natural history of MS cohorts described in Olmsted County, Minnesota, and in Lyon, France, suggested that MS patients became disabled around the same age regardless of treatment.1,2 Therefore, even after the development of disease-modifying therapies (DMTs), the concept of medical futility remained in the field.
- Type
- Chapter
- Information
- Multiple SclerosisA Practical Manual for Hospital and Outpatient Care, pp. 145 - 156Publisher: Cambridge University PressPrint publication year: 2021
References
Mayr, WT, Pittock, SJ, McClelland, RL, et al. Incidence and prevalence of multiple sclerosis in Olmsted County, Minnesota, 1985–2000. Neurology. 2003;61(10):1373–7.CrossRefGoogle ScholarPubMed
Confavreux, C, Vukusic, S, Moreau, T, Adeleine, P. Relapses and progression of disability in multiple sclerosis. N Engl J Med. 2000;343(20):1430–8.CrossRefGoogle ScholarPubMed
Bruck, W, Stadelmann, C. Inflammation and degeneration in multiple sclerosis. J Neurol Sci. 2003;24(suppl 5):S265–7.Google ScholarPubMed
McKay, KA, Kwan, V, Duggan, T, Tremlett, H. Risk factors associated with the onset of relapsing-remitting and primary progressive multiple sclerosis: a systematic review. Biomed Res Int. 2015;2015:817238.Google Scholar
Leray, E, Yaouanq, J, Le Page, E, et al. Evidence for a two-stage disability progression in multiple sclerosis. Brain. 2010;133(Pt 7):1900–13.Google Scholar
Confavreux, C, Vukusic, S, Adeleine, P. Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process. Brain. 2003;126(Pt 4):770–82.Google Scholar
Kappos, L, Edan, G, Freedman, MS, et al. The 11-year long-term follow-up study from the randomized BENEFIT CIS trial. Neurology. 2016;87(10):978–87.CrossRefGoogle ScholarPubMed
Hua, LH, Fan, TH, Conway, D, et al. Discontinuation of disease-modifying therapy in patients with multiple sclerosis over age 60. Mult Scler. 2018:1352458518765656.Google Scholar
MS F. Multiple sclerosis therapeutic strategies: use second-line agents as first-line agents when time is of the essence. Neurol Clin Pract. 2011;1(1):66–8.Google Scholar
Damasceno, A, Damasceno, BP, Cendes, F. No evidence of disease activity in multiple sclerosis: implications on cognition and brain atrophy. Mult Scler. 2016;22(1):64–72.CrossRefGoogle ScholarPubMed
Uher, T, Havrdova, E, Sobisek, L, et al. Is no evidence of disease activity an achievable goal in MS patients on intramuscular interferon beta-1a treatment over long-term follow-up? Mult Scler. 2017;23(2):242–52. doi:10.1177/1352458516650525Google Scholar
De Stefano, N, Airas, L, Grigoriadis, N, et al. Clinical relevance of brain volume measures in multiple sclerosis. CNS Drugs. 2014;28(2):147–56.Google Scholar
Wolinsky, JS, Montalban, X, Hauser, SL, et al. Evaluation of no evidence of progression or active disease (NEPAD) in patients with primary progressive multiple sclerosis in the ORATORIO trial. Ann Neurol. 2018;84(4):527–36.CrossRefGoogle ScholarPubMed
Lublin, F, Miller, DH, Freedman, MS, et al. Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a Phase 3, randomised, double-blind, placebo-controlled trial. Lancet. 2016;387(10023):1075–84.Google Scholar
Havrdova, E, Galetta, S, Hutchinson, M, et al. Effect of natalizumab on clinical and radiological disease activity in multiple sclerosis: a retrospective analysis of the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) study. Lancet Neurol. 2009;8(3):254-60.CrossRefGoogle ScholarPubMed
Wattjes, MP, Steenwijk, MD, Stangel, M. MRI in the diagnosis and monitoring of multiple sclerosis: an update. Clin Neuroradiol. 2015;25(suppl 2):157–65. doi:10.1007/s00062-015-0430-yCrossRefGoogle ScholarPubMed
Pardo, G, Jones, DE. The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations. J Neurol. 2017;264(12):2351–74. [Published correction appears in J Neurol. 2017;264(12):2375–77]. doi:10.1007/s00415-017-8594-9Google Scholar
Beck, RW, Chandler, DL, Cole, SR, et al. Interferon beta-1a for early multiple sclerosis: CHAMPS trial subgroup analyses. Ann Neurol. 2002;51(4):481–90.CrossRefGoogle ScholarPubMed
Comi, G, Filippi, M, Barkhof, F, et al.Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomised study.Lancet. 2001;357(9268):1576–82.Google Scholar
Kappos, L, Edan, G, Freedman, MS, et al. The 11-year long-term follow-up study from the randomized BENEFIT CIS trial. Neurology. 2016;87(10):978–87.CrossRefGoogle ScholarPubMed
Comi, G, Martinelli, V, Rodegher, M, et al. Effect of glatiramer acetate on conversion to clinically definite multiple sclerosis in patients with clinically isolated syndrome (PreCISe study): a randomised double-blind, placebo-controlled trial. Lancet. 2009;374(9700)1503–11.Google Scholar
Degenhardt, A, Ramagopalan, SV, Scalfari, A, et al. Clinical prognostic factors in multiple sclerosis: a natural history review. Nat Rev Neurol. 2009; 5: 672–82.CrossRefGoogle ScholarPubMed