Department of Neurology, Multiple Sclerosis Center, IRCCS Ospedale San Raffaele, Milan, Italy.
Department of Neurology, Medical University of Vienna, Vienna, Austria.
Curr Opin Neurol. 2020 Jun;33(3):286-294. doi: 10.1097/WCO.0000000000000824.
To summarize the currently known side effects of the approved therapies of multiple sclerosis and to suggest monitoring procedures.
The progress in the treatment of multiple sclerosis with new very effective therapies is accompanied by a number of side effects. Some of these have already been described in the approval studies, but some only after approval in a real world situation. The reason for this is the short duration of the clinical studies, the very heterogeneous patient profile in the real world setting with a number of comorbidities, pretherapies, and wider age range. The side effects may occur during application of therapies or afterwards during the course of the treatment. The side effects may range from mild infections, mild laboratory abnormalities, secondary autoimmune diseases to life-threatening side effects such as progressive multifocal leukoencephalopathy.
It has to be pointed out that these side effects are not to be considered as final and neurologists should be vigilant against new unknown side effects. The doctor should be aware of these undesirable effects, should weigh the benefits of the therapies against the risks, but at the same time she/he should keep in mind that multiple sclerosis can be a very disabling disease if not treated properly.
总结多发性硬化症已批准疗法的已知副作用，并提出监测方案。
多发性硬化症的治疗新进展带来了许多副作用，其中一些在批准研究中已经描述过，但有些副作用仅在实际应用中发现。原因是临床试验时间短，真实世界环境中患者的异质性较大，存在多种合并症、预处理和更广泛的年龄范围。副作用可能发生在治疗过程中或之后。副作用范围从轻度感染、轻度实验室异常、继发性自身免疫性疾病到危及生命的副作用，如进行性多灶性白质脑病。
需要指出的是，这些副作用并非最终结果，神经科医生应警惕新的未知副作用。医生应该了解这些不良影响，权衡治疗的益处和风险，但同时也应该记住，如果不进行适当治疗，多发性硬化症可能会导致严重残疾。
