a Neurology , Centre Hospitalier Universitaire de Montpellier , Montpellier , France.
b Faculty of Medicine, Neurology , McGill University , Montreal , Canada.
Expert Rev Neurother. 2019 Jul;19(7):695-706. doi: 10.1080/14737175.2019.1627201. Epub 2019 Jun 26.
: The number of immunomodulatory options approved for multiple sclerosis has increased over the past years, resulting in a better control of the disease. Depending on disease activity, neurologists can now propose treatments with different levels of efficacy, from injectable and oral treatments with modest efficacy, to highly active immunosuppressants. Nevertheless, this gain in efficacy has come with an increase in the global burden of treatment-related adverse events. : The authors have reviewed extensively the existing literature to gain insight into the adverse events associated with disease modifying therapies, so as to help neurologists choose the right treatment for their patients. The authors classified and summarized the adverse events based on frequency, severity and relevance. : As the number and diversity of adverse events is expected to increase, careful surveillance of patients under treatment will be even more important. The characteristics of the MS population, i.e. mainly young women of childbearing age, who will remain treated for decades, and the need for serial administration of distinct treatments with different mechanisms of action highlights the importance of a comprehensive risk-benefit assessment.
: 近年来,批准用于多发性硬化症的免疫调节药物增多,使疾病得到了更好的控制。根据疾病的活动程度,神经科医生现在可以提出不同疗效级别的治疗方案,从疗效适中的注射和口服药物,到高效的免疫抑制剂。然而,这种疗效的提高伴随着治疗相关不良事件的全球负担增加。 : 作者广泛回顾了现有文献,以深入了解与疾病修正治疗相关的不良事件,从而帮助神经科医生为患者选择正确的治疗方案。作者根据频率、严重程度和相关性对不良事件进行了分类和总结。 : 随着不良事件的数量和种类预计会增加,对接受治疗的患者进行仔细监测将变得更加重要。多发性硬化症患者的特点是,他们主要是处于生育年龄的年轻女性,需要数十年的治疗,并且需要连续使用具有不同作用机制的不同治疗方法,这突出了全面的风险效益评估的重要性。