Freedman Mark S, Devonshire Virginia, Duquette Pierre, Giacomini Paul S, Giuliani Fabrizio, Levin Michael C, Montalban Xavier, Morrow Sarah A, Oh Jiwon, Rotstein Dalia, Yeh E Ann
The University of Ottawa and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
University of British Columbia, Vancouver, British Columbia, Canada.
Can J Neurol Sci. 2020 Jul;47(4):437-455. doi: 10.1017/cjn.2020.66. Epub 2020 Apr 6.
The Canadian Multiple Sclerosis Working Group has updated its treatment optimization recommendations (TORs) on the optimal use of disease-modifying therapies for patients with all forms of multiple sclerosis (MS). Recommendations provide guidance on initiating effective treatment early in the course of disease, monitoring response to therapy, and modifying or switching therapies to optimize disease control. The current TORs also address the treatment of pediatric MS, progressive MS and the identification and treatment of aggressive forms of the disease. Newer therapies offer improved efficacy, but also have potential safety concerns that must be adequately balanced, notably when treatment sequencing is considered. There are added discussions regarding the management of pregnancy, the future potential of biomarkers and consideration as to when it may be prudent to stop therapy. These TORs are meant to be used and interpreted by all neurologists with a special interest in the management of MS.
加拿大多发性硬化症工作组更新了其治疗优化建议（TORs），内容涉及针对所有形式的多发性硬化症（MS）患者优化使用疾病修正疗法。这些建议为在疾病进程早期启动有效治疗、监测治疗反应以及调整或更换疗法以优化疾病控制提供了指导。当前的TORs还涉及儿童MS、进展型MS的治疗以及该疾病侵袭性形式的识别与治疗。更新的疗法疗效更佳，但也存在必须充分权衡的潜在安全问题，尤其是在考虑治疗顺序时。此外还讨论了妊娠管理、生物标志物的未来潜力以及何时停止治疗可能较为审慎等问题。这些TORs旨在供所有对MS管理有特殊兴趣的神经科医生使用和解读。
